Penis & scrotum
Dysplasia / carcinoma in situ
Bowenoid papulosis
Authors: Alcides Chaux, M.D., Antonio L. Cubilla, M.D.
Topic Completed: 1 April 2010
Minor changes: 28 October 2020
Copyright: 2002-2021, PathologyOutlines.com, Inc.
PubMed Search: Bowenoid papulosis penis
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology | Clinical features | Prognostic factors | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Chaux A, Cubilla AL. Bowenoid papulosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumbowenoid.html. Accessed August 2nd, 2021.
Definition / general
- Benign HPV related condition characterized by multiple soft papules, most commonly in the skin of the shaft, that usually regress spontaneously (eMedicine: Bowenoid Papulosis [Accessed 3 April 2018])
- Originally described in 1977 by Kopf and Bart (J Dermatol Surg Oncol 1977;3:265)
Terminology
- Type of penile intraepithelial neoplasia (males) or vulvar intraepithelial neoplasia (females)
Epidemiology
- Preferentially affects sexually active young males (mean age 30 years)
Sites
- Primarily penile shaft; may also be present in foreskin, glans or scrotum
Etiology
- 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
Treatment
- 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
AFIP images
Two small papules with irregular margins
Images hosted on other servers:
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
AFIP images
Acanthosis and spotty distribution of atypical cells
Images hosted on other servers:
Epidermal dysmaturation and dyskeratosis
Acanthosis and epidermal dysmaturation / dyskeratosis
Differential diagnosis
- Penile intraepithelial neoplasia: different clinical history; atypical cells are more diffuse, less maturation of keratinocytes
