|LETTER TO EDITOR
|Year : 2019 | Volume
| Issue : 1 | Page : 60-61
Dermoscopy of Bowen's Disease
Yasmeen Jabeen Bhat1, Safia Bashir1, Rohi Wani2, Iffat Hassan1
1 Department of Dermatology, Government Medical College, Srinagar, Jammu and Kashmir, India
2 Department of Patholology, Government Medical College, Srinagar, Jammu and Kashmir, India
|Date of Web Publication||13-Jun-2019|
Yasmeen Jabeen Bhat
Department of Dermatology, Government Medical College, Srinagar, Jammu and Kashmir
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bhat YJ, Bashir S, Wani R, Hassan I. Dermoscopy of Bowen's Disease. Indian J Dermatopathol Diagn Dermatol 2019;6:60-1
A 70-year-old male patient presented to our department with a single, asymptomatic lesion on the right inner thigh which was gradually increasing in size for the last 1 year. On examination, a single, well-defined, erythematous, scaly plaque (approximately 2 cm × 1.5 cm in size) was seen on the medial aspect of the right thigh [Figure 1]. Dermoscopy of the lesion demonstrated coiled vessels arranged in clusters and white rosettes [Figure 2]a and [Figure 2]b. Histopathology of the lesion revealed individual cell keratinization with full-thickness dysplasia and dilated tortuous capillaries in the superficial dermis, which was consistent with the diagnosis of Bowen's disease [Figure 3].
|Figure 1: Erythematous, scaly plaque on the medial aspect of the right thigh|
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|F igure 2 : (a) Mild scaling and clustered red dots (white circle and blue arrows) (non-polarized mode, Dermlite DL3N, California, USA, ×10). (b) Coiled vessels (blue arrow) in clusters (white circle) with white rosettes (yellow arrow) (polarized mode, Dermlite DL3N, California, USA, ×10)|
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|Figure 3: Photomicrograph showing full-thickness dysplasia and individual cell keratinization (yellow arrow) with dilated and tortuous vessels in the superficial papillary dermis (green arrow) (H and E, ×200)|
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Bowen's disease was first described by John T Bowen in 1912. Bowen's disease is a squamous cell carcinoma in situ with a 3%–5% risk of developing into invasive squamous cell carcinoma. The highest incidence of Bowen's disease is found in individuals more than 60 years of age. The disease presents as asymptomatic, slowly enlarging, erythematous, scaly plaques or patches which may become hyperkeratotic, crusted, or ulcerated.
Dermoscopy of Bowen's disease typically demonstrates glomerular and dot vessels grouped in clusters (glomerular vessels are tortuous capillaries often distributed in clusters, usually larger than dotted vessels) and surrounded by a white halo (sign of keratinization) and surface scales. Glomerular vessels are more prominent in the polarized mode of dermoscopy and correspond to the dilated and tortuous vessels in the superficial papillary dermis. Pigmented lesions show brown globules regularly packed in a patchy distribution and also gray-to-brown homogeneous pigmentation. White rosettes can also be seen which appear due to the optical interaction of polarized light with the skin around follicular infundibulae, where there is an interface between parakeratosis and orthokeratosis. Recently, two new features namely double-edge sign (two parallel pigmented edges at the periphery of the lesion) and clusters of brown structureless areas were described in the dermoscopy of Bowen's disease. Dermoscopy can thus be useful for diagnosing Bowen's disease, owing to the presence of these typical morphological features.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kao GF. Carcinoma arising in Bowen's disease. Arch Dermatol 1986;122:1124-6.
Zalaudek I, Argenziano G, Leinweber B, Citarella L, Hofmann-Wellenhof R, Malvehy J, et al.
Dermoscopy of Bowen's disease. Br J Dermatol 2004;150:1112-6.
Yang Y, Lin J, Fang S, Han S, Song Z. What's new in dermoscopy of Bowen's disease: Two new dermoscopic signs and its differential diagnosis. Int J Dermatol 2017;56:1022-5.
[Figure 1], [Figure 2], [Figure 3]