Dermoscopic Rainbow pattern

in non-Kaposi lesions: Our experience

N Knpfel1, LJ del Pozo1, C Saus2, MM Escudero-Gngora1, O Corral-Magaa1, A Giacaman1, C Gmez2 and A MarEn-SanFago1
Departments of 1Dermatology and 2Pathology. Hospital Universitari Son Espases. Palma de Mallorca. Spain

Introduction and Objectives:

The rainbow paRern was rst recognized by Hu et al. in
2009 as a mulFcoloured paRern of the rainbow spectrum.
Although it was iniFally considered to be a characterisFc
feature of Kaposi sarcoma, it has since been observed in
various lesions of dierent eFologies, including basal cell
carcinoma, melanoma, atypical broxanthoma, stasis
dermaFFs, lichen planus and skin scars. The purpose of our
study was to caracterize skin condiFons that showed a
rainbow paRern on dermoscopy, excluding Kaposi
sarcoma. Our secondary end point was to establish
dermoscopic-histopathologic correlaFon of the areas
exhibiFng a mulFcoloured paRern.

PYOGENIC GRANULOMA
LocaFon: index nger

Histological ndings corresponding to rainbow

paRern on dermoscopy. Prominent vascular
structures are shown. (H/E X20)

BASAL CELL CARCINOMA

LocaFon: head (temple)

Material and Methods:

RetrospecFve study between 2005-2015 of all lesions
evaluated in the oncodermatology clinic that showed a
rainbow paRern on dermoscopy with a histopathological
proven diagnosis. Kaposi sarcoma lesions were excluded.

Histological ndings corresponding to rainbow

paRern on dermoscopy. Basal cell carcinoma with
a dense inammatory inltrate on the upper
dermis. (H/E X20)

Results:
Twelve lesions were idenFed. Histopathologic diagnosis
were basal cell carcinoma (5), pyogenic granuloma (2),
nodular melanoma (2), angiokeratoma (1), atypical
broxanthoma (1) and merkel cell carcinoma (1).

ANGIOKERATOMA
LocaFon: ank

ATYPICAL FIBROXANTHOMA
LocaFon: head (scalp)

NODULAR MELANOMA
LocaFon: arm

NODULAR MELANOMA
LocaFon: arm

Conclusions
The rainbow pa1ern represents an op3cal eect only observed under polarized dermoscopy in which polarized light interacts with various elements as it passes through 3ssue.
This mul3coloured pa1ern was originally reported to be more frequent in papular or nodular-type lesions in Kaposi sarcoma and our results show that it is also present in
other cutaneous tumours with rich vasculariza3on. This pa1ern was not associated with any par3cular histological structure, though it may express prominent vascular-lumen
rich structures in the stromal 3ssue.
References
1 Cheng ST, Ke CL, Lee CH et al. Rainbow paRern in Kaposis sarcoma under polarized dermoscopy: a dermoscopic pathological study. Br J Dermatol 2009;160:8019
2 Vazquez-Lopez F, Garcia-Garcia B, Rajadhyaksha M, Marghoob AA. Dermoscopic rainbow paRern in non-Kaposi sarcoma lesions. Br J Dermatol 2009;161:474-5

3 Hu SC, Ke CL, Lee CH, Wu CS, Chen GS, Cheng ST. Dermoscopy of Kaposis sarcoma: Areas exhibiFng the mulFcoloured rainbow paRern. J Eur Acad Dermatol Venereol.
2009;23:1128-32
4 SaRa R, Fresi L, CoRoni F. Dermoscopic rainbow paRern in Kaposi's sarcoma lesions: our experience. Arch Dermatol. 2012;148:1207-8
5 Pitarch G. Dermoscopic rainbow paRern in atypical broxanthoma. Actas Dermosiliogr. 2014;105:97-9