lymphangioma circumscriptum ( lc ) or microcystic lymphatic malformation is a hamartomatous malformation of the lymphatic channels of the skin .
treatment of lc is difficult because of the persistent nature of the disease due to deeper subcutaneous cisternal connections .
we report here a case of lc treated effectively with radiofrequency ablation without any recurrence .
a 16-year - old male with fitzpatrick skin type v presented to our clinic with partially fluid - filled lesions on left upper arm with slight local swelling .
the patient had these lesions since the age of 2 years and had been repeatedly treated with antibiotics for local infection .
examination showed a well - defined plaque on left upper arm with grouped vesicular lesions , giving the typical appearance of a 
a biopsy was taken from the edge of the lesion and histopathology showed multiple thin - walled , dilated lymphatic spaces in the papillary dermis and these spaces contained lymph and few erythrocytes .
the overlying epidermis was thin , and there were elongated rete ridges that appeared to surround the lymphatic channels .
the patient was given a systemic antiobiotic , cefadroxil 500 mg twice daily for 5 days , to treat the infection including oozing from the lesions and to decrease the inflammation .
radiofrequency ablation was done a week later ( basco radiofrequency device , model rf - b2 , high frequency 2 mhz , power < 150 w ) , in cut and coagulate mode with wire loop electrode , under local anesthesia .
the patient was advised to clean the area with betadine lotion and apply topical antibiotic mupirocin on the lesions .
three sessions were required at weekly intervals for the lesions to clear as some deeper components were left untreated at the first two sessions .
one week after last treatment , the area had partially healed with slight depigmentation . at 1 month , the lesions had completely healed and swelling had subsided [ figure 1 ] .
no recurrence has occurred in the past 1 year and the patient is still under surveillance .
( a ) lc lesion on the left upper arm ; ( b ) lesions being treated with radiofrequency ablation ; ( c ) immediate post treatment red erythematous area ; ( d ) complete healing of the lesions at 1 month
lc is benign ectasia with two components : the clinically obvious , dermal vesicular component , visible on the skin , and the deeper subcutaneous cisternal element .
whimster described the pathogenesis and said that lc arises from the subcutaneous muscle - coated lymphatic cisterns which receive lymphatic flow from the surrounding tissue , but this is not drained to the normal lymphatic system .
these dilated cisterns conduct the lymph through communicating channels into the dermal thin lymphatics , which balloon out into the epidermis .
treatment modalities include surgical excision , lasers and sclerotherapy with varying success.[35 ] we tried the radiofrequency ablation to treat lc , which produced near - complete clinical ablation with coagulation of lesional and perilesional skin leading to fibrosis of the perivesicular lymphatics .
the follow up was longer in our case , i.e. , 1 year and we are encouraged to do a case series to determine the efficacy of radiofrequency in this notorious condition .
 lymphangioma circumscriptum ( lc ) , a hamartomatous lymphatic malformation , is a therapeutic challenge for the dermatologist . 
 various modalities like surgical excision , lasers , and sclerotherapy have been used in the past to treat this notorious skin condition . 
 we report the efficacy of a radiofrequency ablation in a patient with lc . 
 the treatment efficacy of radiofrequency was satisfactory in our patient with no recurrence during 1 year follow - up period . 
 the radiofrequency technique is a safe and economic treatment for management of lc . 
Introduction
Case Report
Discussion