10.5826/dpc.1202a46
text/xml
2160-9381
1803
en
Francisco Javier  Salazar-Torres
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
nevus
Dermoscopic Rainbow Pattern in a Deep Penetrating Nevus
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2022-05-02
2021-05-24
2022-05-02
2022-05-24
e2022046
Dermatol Pract Concept
Francisco Javier  Salazar-Torres
2022/05/02
10.5826/dpc.1202a46
e2022046
Instituto Dermatológico de Jalisco “Dr. José Barba Rubio”, Pediatric Dermatology Department Federalismo 3102, Zapopan, México
2160-9381
nevus
en
e2022046
Strazzula L, Senna MM, Yasuda M, Belazarian L. The deep penetrating nevus. J Am Acad Dermatol. 2014;71(6):1234-1240. DOI: 10.1016/j.jaad.2014.07.026. PMID: 25175710.2 Cosgarea I, Griewank KG, Ungureanu L, Tamayo A, Siepmann T. Deep Penetrating Nevus and Borderline-Deep Penetrating Nevus: A Literature Review. Front Oncol. 2020;10:837. DOI: 10.3389/fonc.2020.00837. PMID: 32509588. PMCID: PMC7251176..
Dermoscopic Rainbow Pattern in a Deep Penetrating Nevus
https://dpcj.org/index.php/dpc/article/download/1803/1565
                    Dermatology Practical & Conceptual


                  Dermoscopic Rainbow Pattern in Deep
                          Penetrating Nevus
    Arturo Robles-Tenorio1, Miriam Sarahí Preciado-Aguiar2, Ricardo Quiñones-Venegas2,
                              Francisco Javier Salazar-Torres2


1 Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, I. Morones Prieto 3000, Monterrey, México
2 Instituto Dermatológico de Jalisco “Dr. José Barba Rubio”, Federalismo 3102, Zapopan, México



Key words: nevus, dermoscopy, dermis, pigmentation, rainbow
Citation: Robles-Tenorio A, Preciado-Aguiar MS, Quiñones-Venegas R, Salazar-Torres FJ. Dermoscopic rainbow pattern in deep
penetrating nevus. Dermatol Pract Concept. 2022;12(2):e2022046. DOI: https://doi.org/10.5826/dpc.1202a46
Accepted: July 27, 2021; Published: April, 2022
Copyright: ©2022 Robles-Tenorio et al. This is an open-access article distributed under the terms of the Creative Commons Attribution
License BY-NC-4.0, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original
authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Arturo Robles-Tenorio, 1Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey.
E-mail: arturo.rt@tec.mx




Introduction                                                             examination, there was an 8 x 5 x 5 mm, well-defined, black,
                                                                         hyperkeratotic nodule with a central erosion (Figure 1A).
The deep penetrating nevus (DPN) is a benign, acquired, me-              Polarized dermoscopy with ultrasound gel immersion
lanocytic lesion that shows intense pigmentation and infil-              showed a pigmented center surrounded by rainbow patterns
tration into the reticular dermis or subcutaneous tissue [1,2].          and bluish-white structureless areas (Figure 1B). An exci-
It affects young individuals before the third decade of life,            sional biopsy with a 3-mm margin was performed. On histo-
primarily in the head and neck region. DPN usually presents              pathology, a benign-appearing, symmetric tumor composed
as an asymptomatic, well-defined, symmetric, solitary, blue,             of epithelioid and spindle-shaped melanocytes extending to
brown, or black, papule or nodule. Due to its clinical and               the hypodermis was observed (Figure 2), compatible with
histopathological similarities, DPN is often confused with               DPN. At the 24-month follow-up there was no recurrence.
malignant melanoma, blue nevus, and Spitz nevus. Since der-
moscopic images of DPN are scarce, its features are not well
established. Here, we present a case of DPN in a patient with
                                                                         Conclusions
Fitzpatrick type V skin that showed the rainbow pattern un-              There are less than 5 dermoscopic descriptions of DPN, in-
der polarized immersion dermoscopy.                                      cluding a globular blue-brown pattern and a polychromatic
                                                                         appearance [1,2]. Polarized immersion dermoscopy is a
Case Presentation                                                        suitable technique to evaluate nodular, melanocytic lesions,
                                                                         especially when hyperkeratosis, fissures, and ridges are pres-
A 13-year-old male with Fitzpatrick type V skin presented                ent. The rainbow pattern and the clinical appearance of DPN
with a 1-year history of an enlarging lesion on the scalp. On            in high Fitzpatrick skin types are rare findings among the




Research Letter | Dermatol Pract Concept. 2022;12(2):e2022046                                                                           1
        Figure 1. Deep penetrating nevus. (A) Clinical appearance. (B) Polarized immersion dermoscopy revealed a pigmented
        center, rainbow patterns (red ovals), and bluish-white structureless areas.



                                                                   available images from the literature. Increasing awareness of
                                                                   this condition in skin of color, as well as selecting an ade-
                                                                   quate dermoscopy technique can help to refine the character-
                                                                   ization of DPN in underrepresented populations.


                                                                   References
                                                                    1. Strazzula L, Senna MM, Yasuda M, Belazarian L. The deep pen-
                                                                       etrating nevus. J Am Acad Dermatol. 2014;71(6):1234-1240.
                                                                       DOI: 10.1016/j.jaad.2014.07.026. PMID: 25175710.2
                                                                    2. Cosgarea I, Griewank KG, Ungureanu L, Tamayo A, Siepmann T.
                                                                       Deep Penetrating Nevus and Borderline-Deep Penetrating Nevus:
                                                                       A Literature Review. Front Oncol. 2020;10:837. DOI: 10.3389/
                                                                       fonc.2020.00837. PMID: 32509588. PMCID: PMC7251176..

Figure 2. Histopathology of deep penetrating nevus. A symmetric
tumor composed of spindle-shaped melanocytes extending to the
deep dermis was observed (H&E x 40).




2                                                                      Research Letter | Dermatol Pract Concept. 2022;12(2):e2022046
