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Skin - Nonmelanocytic tumors

Premalignant or noninvasive

Bowen’s disease


Reviewer: Christopher Hale, M.D. (see Reviewers page)
Revised: 4 July 2012, last major update June 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Usually on skin NOT exposed to sunlight, such as trunk
● Called erythroplasia (of Queyrat) if at glans penis, vulva, oral cavity
● Often considered as carcinoma in situ or squamous intraepidermal neoplasia

Case reports
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● 36 year old man with pigmented Bowen’s disease (Ann Dermatol 2009;21:197)

Clinical images
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Solitary black colored verrucous scaly plaque on umbilicus


Erythematous scaly plaque with crusting on palm

Gross description
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● Slightly raised, large scaly erythematous plaque with irregular border
● Usually single patch or verrucous growth

Micro description
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● Atypia is prominent and throughout epidermis
● Includes nuclear hyperchromasia and multinucleation, individual cell dyskeratosis, increased mitotic figures, atypical mitotic figures
● Also cytoplasmic vacuoles, markedly altered maturation, but usually still some surface keratinization
● May extend into eccrine sweat glands (not considered invasive disease)
● Intercellular bridges present
● Rarely pagetoid cells or ground glass cytoplasm

Micro images
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Contributed by Dr. Amy Lynn, Toledo, Ohio

       
Various images

Positive stains
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● p53, HPV, high molecular weight cytokeratin

Molecular
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● Aneuploid

Differential diagnosis
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● Bowenoid actinic keratosis: circumscribed, in sun-exposed areas with clinical appearance of actinic keratosis
● Chronic arsenic ingestion

End of Skin - Nonmelanocytic tumors > Premalignant or noninvasive > Bowen’s disease


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