Bowen's disease

Diagnosis: Bowen's disease

Well-defined, erythematous and scaly plaque with crusted areas on chest area.

Clinical Presentation

Well-defined, erythematous and scaly plaque with crusted areas on chest area.

Clinical History

Submitted by Alaa Saad. Originally posted September 22, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Actinic keratosis • Superficial basal cell carcinoma • Psoriasis (plaque) • Nummular eczema • Paget disease (extramammary) • Tinea corporis • Amelanotic melanoma in situ

Key Learnings

• Squamous cell carcinoma in situ — full-thickness epidermal atypia • ~3-5% risk of progression to invasive SCC • Arsenic exposure associated with multiple Bowen disease lesions • HPV-related Bowen disease (bowenoid papulosis) occurs in genital areas in younger patients • Dermoscopy: glomerular (coiled) vessels with scaly surface • When pigmented, may mimic melanoma — biopsy essential

Tags: bowen039s, disease, alaa saad