Bowenoid Papulose

Lloyd 1970

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

Young patients mostly between 20-30 years.

Pigmented, verrucous maculae and papules. In the area of the mucous membrane they appear a little brighter.

• Clinical image
• Biopsy
• PCR with HPV typing

Genitoanal and on the mucous membranes.

Hyperplastic epidermis, mitoses, dyskeratotic keratinocytes.

• The transition to an invasive squamous cell carcinoma is estimated at approximately 1%-2.6%.
• Patients are highly infectious, partners should be examined regularly
• Frequent relapses

• Abstinence
• Excision by laser or curette.
• Cryotherapy
• Imiquimod 5% cream (off-label-use):
  • Application: 5x/ week over several weeks, maximum 16 weeks
  • Side effects: Redness, itching, burning, erosion of the skin. Patients should be informed about this before starting the therapy!
• With regard to the increased risk of HPV 16 and 18 carcinoma, the partner should be examined when 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.