Dermatologist Questions Dermapathologist


I had a black lesion on the back of my thigh about a year and a half ago. It started out as a dot and rapidly grew to a hard, crusty 6-8mm mass over about 2-3 weeks. I went to my doctor about it due to the color and rapid growth. He suggested it was a thrombosed hemangioma and referred me to dermatology. By the time I was due to see the dermatologist, I had snagged the thing on my clothes which ripped it off. It bled profusely, thick and black, but I was able to get it to stop by applying pressure and a bandage. It seemed to heal quickly and left only a vague pink spot that faded to seemingly normal skin with no sign that it was ever there (not even showing vessels or the likes under magnification during the scar phase).

The mark appeared again at some point - to my knowledge in the same spot with the same characteristics - currently a small 2-3mm black spot. I was just hoping to get some thoughts - if it's common for thrombosed hemangiomas to totally disappear without literally any visible sign of their previous existence and then reappear over a year later. I also wonder if the thick, black blood is perhaps that the bleed itself is caused by a capillary that has been oxygen-starved due to compression and maybe just a spontaneous bleeds deep under the skin rather than a true hemangioma? I have had bleeds on my feet and hands, which my doctor has told me is caused by the capillaries being cramped due to inflammation, though despite these appearing black to the naked eye they usually appear red or brown under magnification.

Male | 33 years old
Complaint duration: 1.5 years
Medications: Sulfasalazine, Humira, Fludrocortisone, Cymbalta
Conditions: Inflammatory Arthritis, Hypovolemia/Dysautonomia

1 Answer


Hemangiomas are benign, but somewhat unsightly and can certainly bleed if traumatized. A somewhat related condition is called "pyogenic granuloma. These lesions (which also contain blood vessels) rapidly form and certainly can bleed, with or without trauma. They may recur if superficially removed. So, if your skin lesion has returned and is enlarging, best to have it checked by your dermatologist. 

Stephen Schleicher, MD
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