Description: lacunar pattern and white veil.

History:

This healthy 48-year-old man with a congenital nevus flammeus had begun to develop small papules within his vascular malformation. Capillary malformation (CM), usually referred to as a port-wine stain or nevus flammeus, is the most common type of vascular malformation. As a congenital malformation of the superficial dermal blood vessels, CM is present at birth and grows in size commensurate with the child; it remains present for life and has no tendency toward involution. Histologically, they are characterized by intradermal vascular ectasias representing capillary malformation.

Dermoscopic description: The lesions reveal a typical lacunar pattern and white veil. In patients with CM, the pre-treatment dermoscopic evaluation enables clinicians to estimate and predict the response to laser treatment. It has been postulated that the venous plexus of CM revealing dotted and/or globular patterns without a gray-whitish veil on dermoscopy is located superficially in the upper dermis and thus predicting a good response to laser treatment. By contrast, the presence of a gray-whitish veil indicates the location of the venous malformation in the deeper parts of the dermis and treatment success should be considered unsure.