Enfermedad de Bowen / Bowen's disease

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).

Bowen's disease of the penile shaft presenting as a pigmented macule: dermoscopy, reflectance confocal microscopy and histopathological correlation,

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.

Anal intraepithelial neoplasia associated with high-grade vulva injury (usual-type vulvar intraepithelial neoplasia): surgical treatment with cutaneous flap advancement

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)

Contribuições de Murray Bowen à terapia familiar sistêmica / Murray Bowens contributions to systemic family therapy

Este artigo apresenta um ensaio teórico sobre as contribuições de Murray Bowen para a Terapia Familiar Sistêmica. Apesar de ser um dos pioneiros da psicologia sistêmica, suas obras nunca foram publicadas em português. Dada a importância da teoria de Bowen para o campo da terapia familiar, este trabalho visa discutir alguns aspectos teóricos e práticos que podem ajudar os profissionais no trabalho com famílias. A partir da descrição dos sistemas emocional, afetivo e intelectual, apresentam-se os oito conceitos de Bowen, com destaque para a diferenciação do self e sua importância na proposta terapêutica boweniana. São ressaltadas duas características distintas da Terapia Familiar Sistêmica de Bowen: a diferenciação do self do terapeuta e a terapia familiar com um só membro da família.

This article is a theoretical essay on Murray Bowen's contributions to systemic family therapy. Despite being one of the pioneers of systemic psychology, his works were never published in Portuguese. Given the importance of Bowen's theory for the field of family therapy, this work aims to explore some theoretical and practical aspects that can help professionals in working with families. From the description of the emotional, affective and intellectual systems, eight concepts of Bowen's theory are presented, highlighting the self differentiation and its importance in the Bowenian therapeutic proposal. Two distinct characteristics of Bowen's Systemic Family Therapy clinic are highlighted, the differentiation of the therapist's self and family therapy with a single family member.

Enfermedad de Bowen de localización inusual / Bowen's disease of unusual location

La enfermedad de Bowen es un carcinoma de células escamosas intraepidérmico con potencial invasor que se ve con mayor frecuencia en mayores de 60 años. Se presenta usualmente como una placa eritematosa de crecimiento lento en zonas fotoexpuestas. Presentamos el caso de una mujer de 65 años con carcinoma escamoso in situ variedad pagetoide localizado en la mama izquierda en el cual fue determinante la inmunohistoquímica para realizar el diagnóstico final.

Collision tumor: pigmented Bowen's disease and seborrheic keratosis

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.

Enfermedad de Bowen: Reporte de un caso / Bowen's disease: A case report

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.

Merkel Cell Carcinoma Originating in a Setting of Pre-existing Bowen's Disease / 대한피부과학회지

No abstract available.

Various Skin Tumors Originating from Disseminated Superficial Actinic Porokeratosis / 대한피부과학회지

Disseminated superficial actinic porokeratosis (DSAP) is a rare keratinization disorder. It is histopathologically characterized by the presence of coronoid lamellae and clinically by lesions showing central atrophy with elevated borders. Squamous cell carcinoma originating in the classical Mibelli subtype of porokeratosis is well-documented; however, few reports have described squamous cell carcinoma in DSAP lesions. We report the case of a 76-year-old woman with DSAP who developed Bowen's disease, actinic keratosis, and keratoacanthoma on her face.

Pagetoid Bowen Disease Initially Misdiagnosed as Ectopic Extramammary Paget's Disease

Pagetoid Bowen disease is a histological variant of Bowen disease which demonstrates large pale staining cells (pagetoid cells). It requires differential diagnosis from other cutaneous malignancies with similar patterns, such as extramammary Paget's disease (EMPD) and Pagetoid melanoma in situ. Herein, we report a case of Pagetoid Bowen disease which was initially misdiagnosed as ectopic EMPD.

Recent advances of basal cell carcinoma, squamous cell carcinoma, and carcinoma in situ

Incidence of basal and squamous cell carcinoma is increasing among Korean. With increasing this incidence we need to attend the management and prevention of these cutaneous malignancies. Basal cell carcinoma (BCC) is the most common skin malignancy. Sun exposure is the most important environmental cause of BCC. Daily sun protection especially avoiding sun exposure between 10 a.m. and 4 p.m. provides most effective prevention against chronic ultraviolet-induced skin damage. Hedgehog pathway inhibitors are used locally advanced and metastatic BCC lesions in Korea. Until recently, there are no reports whether it developed resistance of Hedgehog pathway inhibitors with advanced BCC in Korean patients. Among malignant skin tumors, 19.1% were squamous cell carcinoma (SCC). The incidence of SCC was rapidly increased over the past years. However, the incidence rate of SCC in Japan has not been changed from the period 1976–1980 to 1986–1990. Sentinel lymph node biopsy for SCC did not provide diagnostic value. Bowen's disease and Erythroplasia of Queyrat are considered as carcinoma in situ of the skin. Erythroplasia of Queyrat have worse prognosis with a higher rate of malignant degeneration. Dermoscopy may helpful tool in assisting the noninvasive diagnosis of carcinoma in situ of the skin.

Pigmented Bowen's disease associated with high-risk HPV simulating melanoma of the hand

Abstract: Bowen's disease is an in situ squamous cell carcinoma of the skin with only 2% of pigmented cases reported. It is clinically characterized by papules and plaques of blackened surface that may be caused either by sun damage - usually in photoexposed areas in elderly individuals - or by human papillomavirus infection - usually in the anogenital region of young adults. Dermoscopic aspects of Bowen's disease are discussed for over a decade, but with no definitive criteria that would lead to a definitive diagnosis. We present a case of Bowen's disease affecting the finger of a 57-year-old Asian patient. The lesion clinically and dermoscopically simulated a melanoma. Histopathological findings suggested the diagnosis of pigmented Bowen's disease. Pigmented Bowen's disease should be considered a differential diagnosis of melanoma, since its clinical and dermoscopic criteria are unspecific. Histopathological examination remains the gold standard for the diagnosis of the disease.

A case of pigmented Bowen's disease

ABSTRACT Pigmented Bowen's disease is a rare subtype of Bowen's disease. Clinically it presents as a slow-growing, well-defined, hyperpigmented plaque, and should be included as a differential diagnosis of other pigmented lesions. The authors describe a challenging case of pigmented Bowen's disease with non-diagnostic dermscopy findings.

Expression of protein kinase D1 and its phosphorylation at tyr463 and ser916 in squamous cell carcinoma, Bowen's disease and actinic keratosis / 中华皮肤科杂志

Objective To measure the expression of protein kinase D1 (PKD1),tyr463-phosphorylaed PKD1 (pPKD1-tyr463) and ser916-phos-phorylaed PKD1 (pPKD1-ser916) in squamous cell carcinoma (SCC),Bowen's disease (BD) and actinic keratosis (AK),and to explore their significance.Methods Fresh tissue samples were resected from lesions of patients with SCC (SCC group),BD (BD group) and AK (AK group),as well as from normal skin of healthy human controls (control group),and each group had a sample size of 10.Real-time RT-PCR was performed to measure the mRNA expression of protein kinase D1 gene (PRKD1),and Western blot analysis to determine the protein expression of PKD1,pPKD1-tyr463 and pPKD1-ser916.In addition,immunohistochemical study was conducted to determine the expression of PKD1,pPKD1-tyr463 and pPKD1-ser916 in another 50 paraffin-embedded skin samples of SCC,20 samples of BD,20 samples of AK and 10 normal skin samples.Results PRKD1 mRNA expression significantly differed among the control group (0.64 ± 0.09),SCC group (5.37 ± 1.06),BD group (2.69 ± 0.72) and AK group (2.43 ± 0.46) (F =21.37,P ＜ 0.05),and was significantly higher in the SCC,BD and AK groups than that in the control group (P ＜ 0.05),as well as in the SCC group than that in the AK and BD groups (both P ＜ 0.05).However,no significant difference in the PRKD1 mRNA expression was observed between the BD group and AK group (P ＞ 0.05).Immunohistochemical study showed that the total PKD1 protein and pPKD1-tyr463 in the SCC and BD groups were mainly expressed in the cytoplasm and cell membrane of spinous layer cells and atypical cells,and their expression rates were significantly higher than those in the AK group and control group (all P ＜ 0.01).The pPKD1-ser916 was only slightly expressed in some cancer nests of well-differentiated SCC tissues,but not in poorly-differentiated SCC,AK,BD tissues and normal skin tissues.In the SCC group,the expression rate of PKD1 increased with the increase of the pathological grade of SCC,and the PKD1 expression was positively correlated with pPKD1-tyr463 expression (rcc =0.479,P ＜ 0.05).Western blot results were consistent with immunohistochemical findings.Conclusion PKD1 and pPKD1-tyr463 may be involved in the development and differentiation of skin tumors derived from stratified squamous epithelium,and PKD1 may exert promotive effects on the formation of cutaneous SCC by activating the Tyr463 phosphorylation site.

Lobulated Bowen's Disease with a Clear Cell Change

Bowen's disease usually manifests as a slowly enlarging erythematous scaly patch or plaque. An uncommon variant of Bowen's disease showing a verrucous appearance has been reported and a distinct variant with a prominent clear cell change on histopathology, in addition to a verrucous surface change, was also reported. We describe novel form of Bowen's disease having a cerebriform appearance and showing histopathologically a significant clear cell change and propose that the clinical term “lobulated Bowen's disease” would be compatible for the description of this unique clinical variant. From a histopathological point of view, the precise definition and etiopathogenesis of the clear cell change in Bowen's disease should be elucidated.

Porokeratosis simulating Bowen's disease on dermoscopy

Abstract Porokeratosis is a disorder of epidermal keratinization characterized by the presence of annular hyperkeratotic plaques. Its etiopathogenesis is not yet fully understood, but a relationship with immunosuppression has been reported. Dermoscopic examination revealed a classic yellowish-white ring-like structure that resembled “volcanic crater contour” – the so-called cornoid lamella. We describe a case of porokeratosis in a female patient with chronic lymphedema, which was similar to Bowen’s disease due to the many glomerular vessels seen on clinical examination and dermoscopy.

Clinical Features of Cutaneous Premalignant Lesions in Busan City and the Eastern Gyeongnam Province, Korea: A Retrospective Review of 1,292 Cases over 19 Years (1995~2013)

BACKGROUND: The global prevalence of premalignant lesions has been continuously increasing in recent years, but there has been little research regarding the distribution and incidence of cutaneous premalignant lesions in Korean populations. OBJECTIVE: We conducted this retrospective study to analyze recent trends in the incidence and clinical patterns of cutaneous premalignant lesions in the Korean population. METHODS: We reviewed 1,292 cases (3,651 lesions) of patients with cutaneous premalignant lesions, including actinic keratosis (AK) and Bowen's disease (BD), from the Department of Dermatology at Dong-A University Hospital (January 1995 to December 2013). RESULTS: The average cutaneous premalignant lesion annual incidence was 1.82%, and the incidence continuously increased from 0.70% to 4.25% over the study period. The most common cutaneous premalignant lesion was AK (75.85%), followed by BD (24.15%). The mean age of onset was 68.76 years (men, 70.89 years; women, 65.56 years), and the male:female ratio of patients was 1:1.52. Major skin cancers, including squamous cell carcinoma (SCC, 8.90%), basal cell carcinoma (BCC, 6.42%), and malignant melanoma (MM, 0.70%), were detected in 15.79% of patients with cutaneous premalignant lesions. Three patients (0.23%) were previously diagnosed with both SCC and BCC. In addition, 59.13% of patients had a single lesion, while 40.87% had multiple lesions. Patient age, history of previous skin cancers, and occupation-related exposure to ultraviolet radiation were more common in patients with multiple lesions. CONCLUSION: Cutaneous premalignant lesion incidence has gradually increased in the Korean population.

Application of confocal laser scanning microscopy in the differentiation between seborrheic keratosis and Bowen′s disease / 中华皮肤科杂志

Objective To evaluate the application value of confocal laser scanning microscopy(CLSM)in the differentiation between seborrheic keratosis and Bowen′s disease. Methods CLSM was used to observe typical skin lesions in 88 patients clinically diagnosed with seborrheic keratosis and 18 patients clinically diagnosed with Bowen′s disease. Then, tissue specimens were resected from these lesions and subjected to histopathological examination. Results CLSM imaging of seborrheic keratosis lesions showed gyrus?like structures and keratin?filled inclusion cysts in the epidermis with trabecula?like extension of rete ridges in all the 88 cases, basal cells arranged in a cordike or radial pattern in 9 cases, and bright reflective structures in the basal layer and dermis in 6 cases. CLSM imaging of Bowen′s disease lesions revealed disorderly arrangement of large, irregularly shaped atypical cells in some areas in the middle and lower epidermis, and infiltration of scattered mononuclear cells in the superficial dermis. Conclusion CLSM images of seborrheic keratosis are different from those of Bowen′s disease, and CLSM may be helpful for their differential diagnosis.

Long-term recurrence of nonmelanoma skin cancer after topical methylaminolevulinate photodynamic therapy in a dermato-oncology department

Abstract: BACKGROUND: Most available studies on the efficacy of topical photodynamic therapy focus on short-to medium-term results. Long-term data are scarce. OBJECTIVE: To evaluate the long-term efficacy of photodynamic therapy with topical methylaminolevulinate to treat Bowen's disease and basal cell carcinoma in the clinical practice setting of a dermato-oncology department. METHODS: The study included patients diagnosed with Bowen's disease or basal cell carcinoma, and who received photodynamic therapy from 2004 to 2008. Treatment protocol and clinical follow-up were standardized. The primary endpoint was clinically observed recurrence in a previous photodynamic therapy-treated area. Descriptive and survival analyses were performed. RESULTS: A total of 31 Bowen's disease lesions and 44 superficial basal cell carcinoma were treated, with a median follow-up of 43.5 months. Recurrence was observed in 14 Bowen's disease lesions (53.8%) and in 11 superficial basal cell carcinoma (33.3%). Significantly higher estimates for recurrence rates were found in patients with Bowen's disease (p=0.0036) or those aged under 58 years (p=0.039). The risk of recurrence was higher in patients with Bowen's disease than in those with superficial basal cell carcinoma and younger patients. CONCLUSIONS: Recurrence should be considered when choosing to treat non-melanoma skin cancer with photodynamic therapy. Younger age and Bowen's disease were independent predictors for long-term recurrence, suggesting the need to establish an extended period of follow-up for this subset of patients.

Pigmented Bowen’s disease: a case report of an unusual variant / Doença de Bowen pigmentada: relato de caso de uma variante rara

ABSTRACTBowen'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.

RESUMOA doença de Bowen é um carcinoma espinocelular in situ com potencial para transformar-se em invasivo. Ela é pigmentada, uma variante rara, possui poucos relatos na literatura e torna-se um problema no diagnóstico diferencial com outros tumores pigmentados. Relatamos o caso de uma paciente de 73 anos, branca, com uma placa acastanhada, assimétrica, com mais de uma cor, em membro superior direito, com evolução de dois anos.