Pigmented Bowen’s disease: a case report of an unusual variant

Milena M Rodrigues,Jorge J Chacha,Nayara C Wiziack,Luiz C Takita

doi:10.5935/1676-2444.20150044

Abstract

Bowen's disease is a squamous cell carcinoma in situ with the potential to turn into invasive carcinoma. Pigmented Bowen's disease is an unusual variant, with few reported in the literature, and becomes a problem in the differential diagnosis with other pigmented tumors. We reported the case of a white female patient, 73-year-old, with a brownish asymmetric plaque, with more than one color, in the right upper limb, with 2-years of follow up.

Highlights

Bowen’s disease (BD) is a squamous cell carcinoma in situ that is typically presented as asymptomatic erythematous plaque, scaly, well-defined borders, and slow growth(1,2); it affects any area of the body, most frequently in sun-exposed areas(1)
The pigmented BD is a rare variant that accounts for less than 2% of BD cases, and is considered difficult to diagnose(2-5)
Pigmented BD should be considered in the differential diagnosis of melanocytic lesions, pigmented basal cell carcinoma, pigmented actinic keratosis, seborrheic keratosis, and solar lentigo – often being associated with the last two(7-9)

Summary

Introduction

Bowen’s disease (BD) is a squamous cell carcinoma in situ that is typically presented as asymptomatic erythematous plaque, scaly, well-defined borders, and slow growth(1,2); it affects any area of the body, most frequently in sun-exposed areas(1). It is more prevalent in the elderly, affecting both sexes(1, 3). It has a rare pigmented variant, with few reports in the literature and difficult diagnosis(1-5). We report a case of pigmented BD in a 73-year-old female patient. Dermoscopy was not performed, because before medical follow up the patient died due to acute myocardial infarction

Case Report

Findings

Discussion