Lymphangioma circumscriptum (LC) is a rare congenital proliferation of the lymphatic vessels characterized by clusters of thin-walled translucent vesicles, often called “frog spawn,” within a specific area. The exact cause of LC is unknown, but it can be present at birth or develop due to damage to lymphatic vessels from various causes. Symptoms may include intermittent swelling, hemorrhage, and lymph leakage, and early evaluation is essential to prevent potential complications such as infection. Fractional CO2 ablation laser therapy offers excellent functional and cosmetic results.

This is a case of a 32-year-old Filipino female patient with a 30-year history of multiple grouped translucent to hemorrhagic vesicles forming warty-like growths on the right axillary area, gradually extending to the arm and scapular area. Histopathological findings of dilated lymphatic channels in the papillary dermis lined by endothelial cells confirmed the diagnosis of Lymphangioma circumscriptum. The patient underwent a series of fractional carbon dioxide laser ablation for treatment. Clinical and subjective improvement of lesions were noted and the patient was satisfied with the outcome.

Lymphangioma circumscriptum remains challenging to treat, given its rarity and significant tendency for recurrence regardless of the treatment modality. In this case, fractional carbon dioxide laser ablation was utilized to manage Lymphangioma circumscriptum (LC), which resulted in satisfactory cosmetic improvement and lasting symptom relief.