A 13-year-old girl with recurrent localized bruising and hemorrhagic skin papules.

CME EDUCATIONAL OBJECTIVES: 1.Identify clinical features of a microcystic lymphatic malformation (MLM).2.Understand evaluation and treatment options for MLM.3.Identify symptom-based management approach for MLM. A 13-year-old white female presented to the pediatric dermatology clinic for a lesion on her right proximal upper extremity. The lesion initially appeared at 5 years of age as a cluster of skin-colored and erythematous papules. Following their appearance, the patient developed recurrent episodes of pain and swelling in the area, followed by bruising and the color of the papules changing to dark red. The symptoms and signs typically progressed over 1 week, spontaneously resolved over several more weeks, but then recurred every 4 to 6 months.