Lymphangioma circumscriptum treated with combination of Bleomycin sclerotherapy and Radiofrequency ablation

Lymphangioma circumscriptum (LC) is a lymphatic malformation presenting with vesiculo-papules or warty lesions, resembling a "frog-spawn". Many treatment modalities have been described but random excision is still often needed. Bleomycin is a safe sclerosant with specific action on the vascular endothelial cells. It has been used extensively in cystic hygromas but its use in LC of the skin has not been documented previously. We present this case with extensive LC of the flank treated with a combination of intralesional bleomycin and radiofrequency ablation in the same sitting. As the lesion was extensive, treatment was done in three sittings, one to each third. Near complete resolution, with no significant recurrence was achieved with a single sitting to each third.