Ann Dermatol.  2017 Aug;29(4):487-490. 10.5021/ad.2017.29.4.487.

Lobulated Bowen's Disease with a Clear Cell Change

• Lee DY
• Choi KH
• Park SH
• Lee JY
• Yoon TY

• KMID: 2388950
• DOI: http://doi.org/10.5021/ad.2017.29.4.487

Abstract

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.

Keyword

Bowen's disease; Clear cell; Lobulated

MeSH Terms

Bowen's Disease*

Figure

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  Fig. 1 A well-demarcated brownish walnut-shaped nodule on the right temple.

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  Fig. 2 (A, B) Marked acanthosis with elongation and thickening of rete ridges and full-thickness atypia and disarray of keratinocytes with a significant clear cell change in the epidermis (H&E; A: ×100, B: ×400). The clear cells shows positive staining for (C) periodic acid-Schiff (PAS) (×200) and negative staining for (D) PAS with diastase (D-PAS) (×200).

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  Fig. 3 (A~C) “Papillated” Bowen's disease. Papillomatous change on histopathology corresponds to clinically verrucous appearance (B: H&E, ×100). (D~F) “Lobulated” Bowen's disease. Marked acanthosis with elongation and thickening of rete ridges on histopathology is represented by clinically cerebriform or walnut-like appearance (E: H&E, ×100). (C, F) Original photographs were modified for schematic illustration.

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