Pigmented Bowen's disease

Abstract

We describe two Afro-Caribbean women who presented with pigmented Bowen's disease. One, a 44-year-old woman, developed a sharply demarcated, irregularly marginated, hyperpigmented plaque with a velvety surface in the perianal area. The other, a 25-year-old woman, developed a well defined, verrucous, hyperpigmented patch on the umbilicus. Histology showed that both cases were Bowen's disease, and subsequent treatment with 5-fluorouracil and cryotherapy led to complete resolution.

A Case of Pigmented Bowen's Disease

“…According to Ragi et al 3 , the pigmented variant represented 1.7% (7 cases) of the 420 collected cases of cutaneous Bowen's disease. Thus far, there has been only 1 case of pigmented Bowen's disease on the umbilicus in the literature 1 , and no such cases have been reported in Korea. This type of lesion commonly presents as a hyperpigmented, sharply marginated plaque with a surface that may be velvety, verrucous or flat, and it is generally asymptomatic [4][5][6] .…”

“…There are characteristically abundant melanin-rich cells in the basal layer. Significant quantities of melanin may be found within the epidermal cells of the basal layer, within the dermal melanophages or within the melanocytes in the affected epithelium [1][2][3] . For our patient, histologic examination revealed full-thickness involvement of the epidermis by atypical keratinocytes.…”

“…Also, our patient had no history of chronic arsenic intoxication, virus infection, trauma or exposure to radiation. Histologically, pigmented Bowen's disease generally shows epidermal dysplasia with abnormal keratinization [1][2][3][4] . The dermis shows no invasion of tumor cells and it sometimes contains a dense infiltrate of lymphocytes or histiocytes.…”

“…It is characterized by slowly growing, sharply demarcated, erythematous plaques that have a scaly or crusted surface 1,6 . Sunlight and chronic arsenic exposure are well-known favorable factors to develop this lesion [1][2][3] .…”

“…Bowen's disease is intraepidermal squamous cell carcinoma (carcinoma in situ) and it has the potential to progress to invasive carcinoma [1][2][3][4][5][6][7] . It is characterized by slowly growing, sharply demarcated, erythematous plaques that have a scaly or crusted surface 1,6 .…”