Diagnosing lymphangioma circumscriptum is usually straightforward based on its clinical presentation and behavior. While the majority of cases exhibit typical features, there may be instances of solitary lesions or atypical appearances. Dermoscopy plays a crucial role in ensuring an accurate diagnosis, with common dermoscopic features including lacunae, vascular structures, white lines, and the hypopyon sign [1-3]. Lacunae manifest as multiple, clustered, well-defined, and variably colored structures with a round to oval shape [1]. Additionally, the hypopyon sign may be observed, characterized by a two-tone lacuna or a color transition from dark (at the bottom) to light (at the upper part) within the same lacuna. This phenomenon is attributed to blood sedimentation in the dilated lymphatic channels [1-3]. The presence of the hypopyon sign and lacunae strongly indicates lymphangioma circumscriptum, underscoring the significance of a comprehensive dermoscopic examination in cases of chronic lesions that resist typical treatments. It is crucial not to misinterpret any perioral lesion with vesicles as a simple case of herpes

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Conflict of Interest: The authors do not declare any conflict of interest.