HPV-associated intraepithelial neoplasia of external genitalia

Abstract

Intraepithelial neoplasia of the external genitalia with the histologic features, but not the clinical characteristics, of Bowen's disease, has been described under several names: bowenoid papulosis (BP) of the penis or genitalia, 1,2 pigmented penile papules with carcinoma in situ changes, 3 multicentric pigmented Bowen's disease (MPBD), 4,5 multicentric Bowen's disease of the genitalia, 6 reversible vulvar atypia, 7 bowenoid atypia of the vulva, 8 bowenoid dysplasia of the vulva, 9 early vulvar carcinoma, 10 vulvar neoplasia in the young, 11 vulvar intraepithelial neoplasia (VIN), 12 penile intraepithelial neoplasia, 13 carcinoma in situ of the vulva, 14 multicentric vulvar carcinoma in situ, 15 and intraepithelial carcinoma of the vulva. 16 The term bowenoid papulosis of the penis is adequate, since it stresses the multifocal and papular type of the lesions, their localization, and histologic pattern. The term multicentric pigmented Bowen's disease is suitable for the confluent, usually heavily pigmented, and somewhat proliferative lesions in women. The relationship between BP or MPBD and Bowen's disease is currently substantiated by the detection of the same type of human papillomavirus (HPV) in lesions recognized as BP or MPBD, and in typical cases of genital Bowen's disease 17 (Obalek S, et al. unpublished observations).