Bowen disease histopathology

Diagnosis: Bowen disease histopathology

Case submitted by dermRounds Dermatology Network to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by dermRounds Dermatology Network. Originally posted June 27, 2008.

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: bowen, disease, histopathology, dermrounds dermatology network