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Introduction: Bowen's disease is a squamous cell carcinoma in situ, the most common malignancy of the nail unit. Presenting more frequently in the fingernails, common risk factors include ionizing radiation, oral exposure to arsenic or pesticides, dyskeratosis congenita, and quite commonly diverse subtypes of HPV. We report the first case of multiple periungual pigmented Bowen's disease in a pediatric patient. Case Presentation: A healthy 13-year-old boy presented with a 9-month history of a pigmented erythematous patch on the proximal nail fold of his 3rd right finger without associated symptoms. A punch biopsy was taken, and the diagnosis of Bowen's disease was made. The patient received photodynamic therapy and three cycles of imiquimod without response, and two new lesions appeared on the first and second right fingers. Surgical removal was performed on all lesions. A polymerase chain reaction detected an HPV type 16. Discussion/Conclusion: Multiple periungual Bowen's disease is rare, with the most frequent risk factors being HPV infection and chronic immunosuppression. Less than 10% of the cases present as longitudinal melanonychia. To date, there are no previous reports of multiple pigmented periungual Bowen's disease. HPV-induced Bowen's disease is usually present in adults aged between 22 and 89 years as persistent verrucae. In this case, koilocytosis and the fact that all lesions appeared on the right hand are suggestive of HPV infection.

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RESUMEN La enfermedad de Bowen es un carcinoma espinocelular in situ que afecta tanto piel como mucosas y que puede progresar hacia un carcinoma espinocelular invasor. Clínicamente se caracteriza por: una placa eritematosa bien definida, de crecimiento lento, bordes irregulares, bien delimitados y escamas o costras suprayacentes. El cuadro clínico se confirma con los datos histopatológicos donde se advierte carcinoma in situ espinocelular. Se presentó un paciente de 35 años con lesión en la piel del hemitórax derecho de 3 años de evolución. Al examen dermatológico presentaba: lesión en placa eritematosa, única, bordes bien definidos, de tamaño 2x2 cm de diámetro, de forma anular, con escamas finas en su superficie, localizada en hemitórax derecho. La piel perilesional mostraba daño actínico crónico. Se realizó exéresis y biopsia de la lesión. Los resultados de la biopsia informaron que el aspecto histológico es consistente con carcinoma espinocelular in situ (enfermedad de Bowen).

ABSTRACT Bowen's disease is a squamous cell carcinoma in situ that affects both skin and mucosa and may progress to invasive squamous cell carcinoma. It is clinically characterized by a well-defined, slow-growing erythematous plaque with irregular, well-demarcated borders and overlying scales or crusts. The clinical presentation is confirmed by histopathological data showing squamous cell carcinoma in situ. We present a 35-year-old male patient with a skin lesion on the right hemithorax of 3 years of evolution. On dermatological examination he presented a single erythematous plaque lesion located on the right hemithorax, with well-defined borders, 2x2 cm in diameter, annular shape and fine scales on the surface. The perilesional skin showed chronic actinic damage. Exeresis and biopsy of the lesion were performed. The biopsy results reported that the histological appearance was consistent with squamous cell carcinoma in situ (Bowen's disease).

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Abstract The penile localization of pigmented Bowen's disease has been rarely reported and has been mostly related to human papillomavirus infection. Early diagnosis and treatment are important to prevent progression to invasive squamous cell carcinoma. However, diagnosis can be challenging because it may be difficult to distinguish from melanoma, even using dermoscopy. Reflectance confocal microscopy may be useful in suggesting the bedside diagnosis before the histopathological confirmation. A case of penile pigmented Bowen's disease is described along with its dermoscopy and reflectance confocal microscopy findings and their correlation with histopathology.

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The penile localization of pigmented Bowen's disease has been rarely reported and has been mostly related to human papillomavirus infection. Early diagnosis and treatment are important to prevent progression to invasive squamous cell carcinoma. However, diagnosis can be challenging because it may be difficult to distinguish from melanoma, even using dermoscopy. Reflectance confocal microscopy may be useful in suggesting the bedside diagnosis before the histopathological confirmation. A case of penile pigmented Bowen's disease is described along with its dermoscopy and reflectance confocal microscopy findings and their correlation with histopathology.

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The aim of the present article is to report the case of a young patient with bowenoid papulosis who was a carrier of other sexually-transmitted infections (STIs), such as HIV and high-grade vulva lesion (usual-type vulvar intraepithelial neoplasia, VIN), and to demonstrate the strategy used to manage the case, as well as to discuss important issues regarding the standardization of intraepithelial lesions. (AU)

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Bowenoid papulosis (BPap) is an uncommon skin disorder linked to human papillomavirus (HPV) infection and characterized clinically by the presence of scattered papules or small plaques, multiple and pigmented, that involve the stratified squamous epithelium. Bowen disease (BD) is recognized as the main differential diagnosis of BPap. An 80-year old white woman was referred for the evaluation of multiple, brown verrucous papules measuring 3 to 4 mm in diameter on the right maxillary gingiva. Histopathological analysis revealed disturbed epithelial maturation with papillary stratified squamous epithelium, koilocytic dysplasia, parakeratosis, acanthosis, basal double-layer, loss of cellular polarity, nuclear hyperchromatism and pleomorphism, scattered mitosoid bodies, and a high degree of cytologic atypia. An immunohistochemical investigation for p53 and Ki67 showed staining of the basal and suprabasal layer, while p16 was strongly expressed in the nuclei of epithelial cells and Bcl-2 was positive only in mitosoid bodies and the lymphocytic inflammatory infiltrate. In situ DNA hybridization was negative for HPV. Oral BPap is an uncommon lesion in which the diagnostic process includes clinical, histopathological, and molecular correlations due to the similarity to aggressive behavior lesions such as BD.

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This article addresses the natural history of the human papilloma virus (HPV) infection to anal squamous intraepithelial lesions, and onto squamous cell carcinoma of the anus. This article provides overviews of the virology, pathophysiology, nomenclature, classification, historical terms, risk factors, clinical evaluation, differential diagnosis, and treatment of HPV infection and its sequelae.

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Abstract: Bowen's disease is a type of squamous cell carcinoma in situ of the skin. The pigmented form is rare and represents less than 2% of cases. We report a case of a 74-year-old black man with a blackened and asymptomatic leg injury for about 6 months. Clinically, and under dermatoscopy, the injury was suggestive of melanoma or melanoacanthoma, and a definitive diagnosis was made by histopathological examination.

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La enfermedad de Bowen es un carcinoma in situ de células escamosas, que puede progresar a un carcinoma epidermoide invasor, por lo que se requiere un diagnóstico y tratamiento adecuados. Se presenta el caso de una mujer de 74 años, con enfermedad de Bowen en el tórax posterior, una localización poco frecuente, la que fuera tratada con crioterapia.

Bowen's disease is an squamous cells carcinoma in situ of that can progress to an invasive squamous cell carcinoma, so an adequate diagnosis and treatment are required. We present the case of a 74-year-old woman with Bowen's disease in the posterior thorax, a rare location, which was treated with cryotherapy.