Traumatic arteriovenous fistulas can present days to years following penetr
ating trauma and are often challenging to diagnose and manage. Patients may
present to the dermatologist with unilateral varicose veins or a pulsatile
mass. Our case illustrates the value of palpation in a careful systematic
approach to any new lesion, especially in the context of previous penetrati
ng trauma. We also discuss the nomenclature of arteriovenous communications
and review their current management.