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Sir, A venous lake is a common, benign, and vascular tumor, especially over the lower lip of the elderly individuals. It commonly presents as asymptomatic, soft, dark-blue to violaceous, compressible papules, and/or nodules on the head and neck. It presents as a cosmetic concern and may occasionally bleed or become painful. We report two cases of venous lake with a rainbow appearance on dermoscopy due to the paucity of literature. A 54-year-old male patient presented with a 3-year history of a single painless bluish swelling over the temple area. The lesion began as a small lesion, which gradually increased in size over 3 years to its present size. There was no history of trauma before the development of the lesion or bleeding from the lesion after trivial trauma or spontaneously. On examination, there was a single, violaceous, soft, well-demarcated compressible, nonindurated, and nonpulsatile swelling of size 5 mm in diameter over the temple area [Figure 1a]. The swelling was blanchable on the diascopy. The dermoscopy was performed using DermLite DL4 (3Gen), ×10. The dermoscopy of the lesion revealed white structures, globules (red, blue, and purple), a structureless pattern with a rainbow appearance [Figure 1b]. The lesion was excised and sent for histopathology, which revealed dilated thin-walled vessels in the dermis filled with RBCs, with an unremarkable epidermis suggestive of a venous lake [Figure 1c and d].Figure 1: (a-d) Single, violaceous, soft, well-demarcated, compressible, nonindurated, nonpulsatile nodule over the temple area (a). white structures, blue-purple globules (yellow star), and structureless pattern (white arrow) with a rainbow appearance on dermoscopy-×10, polarized mode (b). Histopathology revealed dilated thin-walled vessels in the dermis filled with blood, with an unremarkable epidermis suggestive of a venous lake (H and E stain, c: ×10; d: ×40)A 50-year-old female, a known case of vitiligo vulgaris presented to us with symptomatic multiple soft, bluish swellings over the tongue, and angle of the mouth for 2 years. On examination, violaceous, soft, well-demarcated, compressible, nonindurated, nonpulsatile swellings of varying sizes are present over the angle of the mouth and buccal mucosa [Figure 2a and b]. On diascopy, the lesion was blanchable [Figure 2c]. The dermoscopy of the lesion revealed blue-purple globules, a structureless pattern, whitish veil with a rainbow appearance [Figure 2d]. Based on the findings mentioned above, the diagnosis of venous lake was reached.Figure 2: (a-d) Violaceous, soft, well-demarcated compressible, nonindurated, nonpulsatile swellings over the angle of the mouth and buccal mucosa (a and b). On diascopy, the lesion was blanchable (c). The dermoscopy (×10, polarized mode) of the lesion revealed blue-purple globules and a whitish veil with a rainbow appearance (d)A venous lake is alternatively known as Bean-Walsh angioma, phlebectasia, or senile hemangioma. The first description of the venous lake was given by Bean and Walsh in 1956. No racial predilection was documented in the literature. As per the literature, the typical age of presentation is 65 years.[1,2] The pathogenesis of venous lake is not fully understood. It is believed to be caused by solar damage to vascular adventitia and dermal elastic fibers. The lesions most often occur on sun-exposed surfaces of the face and neck, especially on the helix, antihelix of the ear, posterior aspect of the pinna, and the vermilion border of the lip.[3] In our cases, a venous lake is described over the lip, tongue, and cheek. In 2018, Lee and Mun gave the dermoscopic description of venous lake as a structureless pattern or globules/clods with purple, red, or blue coloration.[4] Mucoscopy of the venous lake showed few red and blue lacunae with a whitish veil.[5] Structureless patterns, or globules or clods are correlated with dilated vascular spaces on histopathology.[4] In our cases, similar dermoscopic findings were observed along with a rainbow pattern. In 2009, the rainbow pattern in patients with Kaposi’s sarcoma (KS), was described by Hu et al. as a bluish-reddish discoloration, together with various colors of the rainbow.[6,7] It was later postulated that these colors correspond to polychromatic lines with no specific histological correlation. This pattern is not specific to KS as it has been described in BCC, melanoma, stasis dermatitis, blue nevi, actinic keratoses, scar, Lichen planus, and other entities.[8] This appearance is thought to be based on a series of physical phenomena, such as diffraction, as the polarized light beam passes through the different skin layers until it reaches to dermis. Venous lakes are sometimes misdiagnosed as melanoma or pigmented basal cell carcinoma (BCC). On diascopy, these conditions can be easily differentiated from venous lakes as they do not change color. Treatment is usually performed for cosmetic reasons. Numerous modalities such as surgical excision, CO2 laser, diode laser, pulsed dye laser, infrared coagulation, cryotherapy, and sclerotherapy have been tried in the treatment of venous lakes.[9] Our report highlights the role of dermoscopy in the diagnosis of venous lakes. We also report a rainbow appearance along with previous dermoscopic findings described in the literature. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Authors’ contributions Literature search: B.B.S, Manuscript preparation: A.M.D, Manuscript editing: J.I.M; Manuscript review: B.B.S. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.