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Dermpath-India Pathology of Bowen's Disease
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Bowen's
disease (squamous cell carcinoma in-situ) presents as scaly erythematous
plaque on the sun-exposed skin in elderly patients.
Etiological factors include prolonged exposure to solar radiation, ingestion of chemical agent (arsenics) or human papillomavirus infection. Arsenic exposure: Major public health hazard - Pathology of Arsenic Poisoning.
Differential diagnosis includes
in-situ
superficial spreading melanoma
and
Extramammary Paget's disease.
Bowenoid papulosis noted in genitalia is histologically similar to squamous cell carcinoma in-situ. However, features favouring the diagnosis of bowenoid papulosis include presence of numerous mitotic figures in metaphase, basophilic inclusions in the granular layer and koilocytes. Erythroplasia of Queyrat represents squamous cell carcinoma in situ presenting on the mucous membranes of the glans penis,vulva and oral mucosa. Differential diagnosis: Bowenoid papulosis is a benign condition in contrast to the malignant behaviour of Bowen's disease and Erythroplasia of Queyrat (EQ). Macroscopically bowenoid papulosis presents as multiple small brown papules usually on the penile shaft. Bowen's disease and Erythroplasia of Queyrat are well defined erythematous plaques in a variety of sites. Bowenoid papulosis and Erythroplasia of Queyrat are seen primarly in men. Bowen's disease occurs
equally in men and women.
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