Bowenoid papulosis

Lloyd 1970

Subtype of condylomata plana. Carcinoma in situ caused by mostly HPV 16 or 18 (rarely also HPV 31-35, 39, 42, 48, 51-54).

Young patients mostly between 20-30 years old.

Pigmented, verrucous macules and papules. They appear a little lighter in the mucous membrane area.

• Clinical image
• Biopsy
• PCR with HPV typing

Genitoanal and on the mucous membranes.

Hyperplastic epidermis, mitoses, dyskeratotic keratinocytes.

• Transition to invasive squamous cell carcinoma is estimated at approximately 1%-2.6%
• Patients are highly infectious, partners should be examined regularly
• Frequent recurrences

• Abstinence
• Excision by laser or curette
• Cryotherapy
• Imiquimod 5% cream (off-label-use):
  • Application: 5x/week for several weeks, maximum 16 weeks
  • NWN: redness, itching, burning, erosion of the skin. Inform the patient about this before starting therapy!

• In view of the increased risk of carcinoma from HPV 16 and 18, partner testing should be performed if the diagnosis is confirmed

1. Wade TR. Bowenoid Papulosis of the Genitalia. Arch Dermatol 1979;115:306.
2. Takayama A, Ishiguro N, Kawashima M. Coexistence of Bowenoid papulosis and Bowen's disease in a patient with systemic lupus erythematosus. J Dermatol 2012;39:646-9.
3. Papadopoulos AJ, Schwartz RA, Lefkowitz A, Tinkle LL, Janniger CK, Lambert WC. Extragenital bowenoid papulosis associated with atypical human papillomavirus genotypes. J Cutan Med Surg 2002;6:117-21.
4. Iwai Y, Someya K, Moriya K, Kobayakawa H, Ohyama T, Horii A. [A case of bowenoid papulosis of the penis]. Hinyokika Kiyo 1989;35:517-21.
5. Deen K, Burdon-Jones D. Imiquimod in the treatment of penile intraepithelial neoplasia: An update. Australas J Dermatol 2016.
6. Majores M, Bierhoff E. [Actinic keratosis, Bowen's disease, keratoacanthoma and squamous cell carcinoma of the skin]. Pathologe 2015;36:16-29.