A dusky red papule

Case presentation

A 23-year-old woman noted a sudden darkening of a longstanding lesion on her right anterior shoulder (Figure 1). Dermoscopy revealed a series of red to blue-black globules separated by a lace-like white veil that outlined the edge of the globules (Figure 2). Skin biopsy demonstrated a cluster of dilated, thin-walled vascular channels filled with red cells immediately beneath the epidermis (Figure 3).