A 51-year-old man is seen for a routine skin check-up. Examination reveals an asymptomatic red-violaceous macule on his left shoulder, which appeared during childhood. Vitropression induces incomplete blanching of the lesion, suggesting a vascular origin. Dermoscopy reveals numerous, relatively well demarcated, oval to linear red lacunae, resembling a school of red fish in a pond (figure 1). Histopathological analysis shows thin-walled, dilated capillaries with neither erythrocyte extravasation nor [...]