Bowenoid Papulosis

Key Points
Pre-cancerous skin condition
Closely related to human papilloma virus (HPV)
Consists of single or multiple small patches or spots on the genitalia of red, brown or flesh color

Bowenoid papulosis is a pre-cancerous skin condition, closely related to human papilloma virus (HPV). Bowenoid papulosis is a very rare type of intraepithelial neoplasia, in which squamous cells of the skin form abnormally, which can lead to cancer. The condition consists of single or multiple patches or spots, occurring on the genitalia. Lesions appear most commonly on the shaft of the penis and the vulva, but may also form on other parts of the genitals or in and around the anus. Occasionally the lesions may become inflamed, itchy, or painful. While most cases are benign, in rare cases the condition may develop into squamous cell carcinoma (penile or vulvar cancer).

Bowenoid papulosis is thought to be transferred much like HPV, through skin to skin sexual contact, so anyone who is sexually active is at risk. Screening is recommended for anyone with a partner who has BP.

Differential Diagnosis (Other conditions with similar appearance)

Genital Warts
Squamous cell carcinoma
Sebaceous carcinoma

Diagnosis
Key Points
Initial diagnosis based on appearance of the affected area
Biopsy is then performed to confirm diagnosis and rule out other conditions

Bowenoid papulosis is initially diagnosed based on the appearance of the affected area. A Biopsy will then be performed to confirm the diagnosis and rule out other, similar-appearing conditions.

Treatment
Most cases are benign and resolve themselves
If the condition is recurrent, treatment consists of the destruction of lesions
In both cases, the affected areas should be re-examined to any changes may be analyzed

Most cases of Bowenoid papulosis are benign, and do not require treatment. However, if the condition is persistent, treatment consists of removing the lesions via destruction. These treatments can include topical options such as phodophyllotoxin or Imiquimod. Other options include clinical application of podophyllin resin, trichloroacetic acid, Fluorouracil cream, or surgical procedures such as Cryotherapy, curettage, and laser ablation.

With all cases of Bowenoid papulosis, due to the increased risk it presents in the development of squamous cell carcinoma, lesions should be examined every 3-6 months to ensure that they have not changed.