Penis and scrotum
Dysplasia / carcinoma in situ
Bowenoid papulosis

Authors: Antonio Cubilla, M.D., Alcides Chaux, M.D. (see Authors page)

Revised: 3 April 2018, last major update April 2010

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Bowenoid papulosis penis

Cite this page: Cubilla, A., Chaux, A. Bowenoid papulosis. website. Accessed July 21st, 2018.
Definition / general
  • Type of penile intraepithelial neoplasia (males) or vulvar intraepithelial neoplasia (females)
  • Preferentially affects sexually active young males (mean age 30 years)
  • Primarily penile shaft; may also be present in foreskin, glans or scrotum
  • Sexually transmitted disease associated with HPV 16 or 18
Clinical features
  • Occurs in young, sexually active population
  • Clinically resembles condyloma but histologically resembles Bowen disease
  • Usually regresses spontaneously (mean duration of disease is 2 months), leaving no sequelae
  • Either macular or papular
  • Less than 1% progress to penile cancer
Prognostic factors
  • None identified
  • Often regresses spontaneously
  • Local agents include 5-fluorouracil, imiquimod, podophyllin and cidofovir (Indian J Dermatol 2009;54:283)
  • Also retinoids (topical or systemic), excision, electrocautery, CO2 laser, cryosurgery, photodynamic therapy and interferon
Clinical images

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Two small papules with irregular margins

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Penile lesions

Typical appearance in female

Gross description
  • Multiple small pigmented papular lesions, may resemble condyloma acuminatum
Microscopic (histologic) description
  • Resembles basaloid PeIN but may have mild / heavy melanin pigmentation within the lesion and atypical cells are more spotty
  • Often spiky or flat appearance
  • May have less cytologic atypia
Microscopic (histologic) images

Images hosted on PathOut server:

Acanthosis and spotty distribution of atypical cells

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Epidermal dysmaturation and dyskeratosis

Acanthosis and epidermal dysmaturation / dyskeratosis

Differential diagnosis