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PubMed1994

Proliferating cell nuclear antigen (PCNA) and p53 protein expression in Bowen's disease.

Bowen's disease is a premalignant dermatosis comprised of a clonal proliferation of atypical keratinocytes in the full thickness of the epidermis. To elucidate the relationship between the alteration of the p53 tumor suppressor protein and cell proliferation rate, we immunohistochemically examined the expression of proliferating cell nuclear antigen (PCNA) and p53 protein in 30 cases of Bowen's disease. All the cases exhibited the full-thickness distribution of PCNA-positive cycling cells in the lesional epidermis. Quantitation of PCNA staining by image cytometry revealed a mean labeling index (LI) of 75.1 +/- 20.3. p53 expression was detected in 13 cases (43%). Expression was diffuse (p53 LI > 50) in 9 cases, but focal (p53 LI < 30) in the other four. The mean PCNA LI of p53 diffusely positive cases was significantly greater than that of both p53 focally positive and p53 negative cases (89.3 +/- 10.1 vs 62.7 +/- 21.2, and 70.5 +/- 21.6; p < 0.01, respectively). These findings suggest that a high-level accumulation of p53 protein results in a more increased cell proliferation in Bowen's disease.

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PubMed1996

[11 cases of anal Bowen's disease].

Bowen's disease of the anal region is a rare, slow-growing, intraepidermal squamous-cell carcinoma (carcinoma in situ). If surgical excision is incomplete, there is a risk of subsequent development of malignancy and metastasis. Between 1980 and 1995 we treated 11 patients (8 female, 3 male) with anal Bowen's disease. The mean age was 55 (34-75) years. The main reason for excision was: pain (4), itching (3), bleeding (3) and a disturbing lump (3). The intraoperative findings were in all cases a lesion at the anocutaneous line: perianal or intra-anal tumor (6), erosion (2) or ulceration (2) as well as lichenoid lesion (4) or hyperpigmentation (3). The procedure was excision of the lesion in 10 cases. Only in one case was a biopsy taken. 3 patients had to be operated on a second time for reasons of radicality. 5 years after primary diagnosis, one patient developed a recurrent invasive squamous-cell carcinoma and had to undergo perineo-abdominal rectum amputation with postoperative radiotherapy (2 years after operation). Only one patient underwent a biopsy, which produced the diagnosis of invasive squamous-cell carcinoma. He underwent combined chemo-radiotherapy. The symptoms of anal Bowen's disease are unspecific and the clinical findings are uncharacteristic. The recommended therapy is complete surgical excision. With complete excision no recurrences do occur.

Adult↗
PubMed1975

Bowen disease associated with porokeratosis of Mibelli.

A 73-year-old woman developed Bowen precancerous dermatosis in an area of porokeratosis of Mibelli on her leg. This is the fourth reported case of Bowen disease arising from porokeratosis of Mibelli. The recent literature indicates that porokeratosis of Mibelli may be due to an abnormal clone of cells, predisposing affected individuals to development of malignant neoplasms over the involved areas.

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PubMedDate not supplied

[Oncogenic human papillomaviruses in extra-genital Bowen disease revealed by in situ hybridization].

BACKGROUND: The association between mucosal oncogenic human papillomaviruses (HPV) and bowenoid papulosis or genital Bowen's disease is well documented. In contrast this association with extra-genital Bowen's disease is poorly studied. The aim of this study was to detect oncogenic (16/18, 31/33/51) and non oncogenic (8/11) mucosal HPV using a in situ hybridization method in 28 skin biopsy specimens of extra-genital Bowen's disease. PATIENTS AND METHODS: Twenty-eight cases of extra-genital Bowen's disease seen in the period 1990-96 in the Dermatology department were included: 19 women and 9 men (mean age: 72 years). Bowen's disease locations were: hands and feet (8 cases), limbs (11 cases), face (8 cases), trunk (1 case). Blinded histopathologic examination confirmed the diagnosis of Bowen's disease and signs of HPV infection (koilocytosis). In situ hybridization was performed using three biotinylated probes detecting HPV types 6/11, 16/18, 31/33/51. RESULTS: Oncogenic HPV genoma was detected in 8 skin samples (28.6 p. 100). In all these cases, 16/18 probe was positive and in two cases, both 16/18 and 31/33/51 probes were positive; 4/8 Bowen's diseases of the extremities were positive for HPV. Koilocytes were found in 6/8 of skin samples with positive HPV detection. DISCUSSION: Mucosal oncogenic HPV are detected by in situ hybridization in 28.6 p. 100 of extra-genital Bowen's disease. In situ hybridization is an easier technique than Southern-Blot hybridization which is the gold standard. Five studies reported similar results and three studies reported different results that we discuss. A precise understanding of oncogenic HPV implication in the development of extra-genital Bowen's disease could lead to the development of new therapeutic strategies (topical cidofovir or imiquimod).

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PubMed1997

Chromosome 11 abnormalities in Bowen disease of the vulva.

Chromosomal cytogenetic abnormalities are common in tumor cells and are often the basis for more detailed chromosomal mapping of tumor suppressor and oncogenes. Chromosome 11 abnormalities are frequently recognized in various neoplasms. We report a case of Bowen disease (squamous cell carcinoma in situ) of the vulva with an isolated 11p cytogenetic abnormality. A chromosome 11 paint confirmed two copies of chromosome 11 in all analyzed metaphases. An 11p subtelomeric probe confirmed an abnormality of 11p15-->pter indicative of a deletion. Previous studies of invasive vulvar cancers also frequently show 11p cytogenetic abnormalities, but never as an isolated finding. The patient suffered from other diseases that may also be related to this locus. Breakage and p53 studies were normal. It is possible that an 11p abnormality in Bowen's disease is a precursor in the evolution of invasive vulva cancer.

Bowen's Disease↗
PubMed2003

Bowen disease of the nail bed presenting as longitudinal melanonychia: detection of human papillomavirus type 56 DNA.

A case of Bowen disease (BD) presenting as longitudinal melanonychia (LM) on the right third fingernail of a 25-year-old African American man is described. Findings from the histopathologic examination revealed full-thickness epidermal atypia, hypergranulosis, and koilocytic changes. Human papillomavirus (HPV) type 56 was identified by polymerase chain reaction. To the best of our knowledge, we describe the first case of BD of the nail unit in which HPV-56 DNA has been identified.

Adult↗
PubMed1989

[Coexistence of multifocal bowen disease of the vulva and cervix carcinoma].

The authors described a case of a young woman with vulva carcinoma with features of multifocal pigmentary Bowen disease coexisting with atypical flat condylomas in the uterine cervix with focuses of carcinoma in situ. Both within the vulva and the uterine cervix there were histological features of carcinoma in situ, virological examination revealed the presence of virus HPV 16 genome. Sparing vulvectomy, the removal of pigmentary changes and electrocoagulation were performed. The authors discussed this rare case and presented therapeutic procedures.

Adult↗
PubMed1994

Pseudo-fibrokeratoma of the nail apparatus with melanocytic pigmentation: a clue for diagnosing Bowen's disease.

Bowen's disease of the nail apparatus is a protean condition where pseudo-fibrokeratoma associated with melanocytic pigmentation was the clue leading to the clinical diagnosis. Migration of melanocytes into the superficial layers of the matrix epithelium may be associated with the extension of the epidermal tumoral process, without necessitating a real melanocytic hyperplasia.

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PubMed2005

Imiquimod 5% cream: a new treatment for Bowen's disease.

Bowen's disease (BD) is a squamous cell carcinoma in situ. Recent studies suggest that human papilloma virus plays an important role in the development of BD. We investigated whether imiquimod 5%, a topical immune response modifier, is an effective treatment for BD in five immunocompetent patients. The lesions were one genital and four extragenital. The frequency of application varied from three times weekly up to twice daily, and treatment duration ranged from 8-24 weeks. Four patients achieved clinical and histological cure. The patient with the genital lesion gained an important reduction in size and infiltration, which enabled surgical removal of the remaining lesion with good functional and cosmetic result. Our results suggest that topical imiquimod 5% is an effective treatment for BD through its viral and antitumor effects.

Adjuvants, Immunologic↗
PubMed2001

[Bowen disease treated with scanned pulsed high energy CO2 laser. Follow-up of 6 cases].

INTRODUCTION: Cutaneous Bowen's disease is an intra-epidermal squamous cell carcinoma. PATIENTS AND METHOD: Ten cases of cutaneous Bowen's disease diagnosed among 8 patients were treated by scanned high energy carbon dioxide laser between November 1996, and March 1998. A biopsy was performed in all patients before treatment. RESULTS: The post-treatment follow-up extended from 1 to 4 years with an average follow-up of 2 years and 11 months. Only one patient, whose lesion was located on the auricle, presented a recurrence after one year. The remaining patients did not present any recurrence during their last control: six patients were followed for two years or more and one patient for one year. We demonstrate a histological and clinical correlation between the number of carbon dioxide laser passes before a clinical endpoint and the thickness of the epidermal carcinoma treated. DISCUSSION: This new treatment has comparable efficacy to other treatments. It can be applied to extensive lesions without sequelae except for the risk of residual hypopigmentation.

Adult↗
PubMed1983

[False forms of Bowen disease of the genital mucosa].

This review deals with the lesions of the genitalia histologically mimicking Bowen's disease, yet behaving like a benign process. The report is based on data from the literature and on 14 personal cases, four of which are described here as examples. Some of the cases, mostly young patients, showed spontaneous regression; in others condylomata acuminata developed on the site of the lesions; in rare instances a "transformation" in lichen planus occurred. For these not really precancerous conditions the at present most widely accepted name is bowenoid papulosis. As far as etiology is concerned, the responsibility of human papilloma virus is generally accepted or considered likely, although there are only very few cases when the virus has really been evidenced. Diagnosis of a pseudo-Bowen's disease can only be made after clinico-pathologic correlation. A careful follow-up is necessary if it has been decided not to destroy the lesion.

Adult↗
PubMed1984

[Detection of papillomavirus capsid antigens and human papillomavirus 16-related DNA in Bowenoid papulosis and Bowen disease].

In one out of 22 cases of histologically diagnosed bowenoid papulosis, we could detect human papilloma virus (HPV) capsid antigen in paraffin sections fixed with formalin by means of the peroxidase-antiperoxidase (PAP) test; there were no positive findings regarding biopsies taken from Bowen's disease. Southern blot hybridization technique revealed HPV 16 DNA in 8 out of 10 cases of bowenoid papulosis; there was one positive identification out of 5 cases of Bowen's disease.

Adult↗
PubMed2002

[A case of sensory perineuritis with Bowen disease].

A 60-year-old man was admitted because of subacutely progressive sensory disturbance characterized by fluctuating dysesthesia and light pain on the skin of his hands and feet. He exhibited mononeuritis multiplex, and a plaque with sloughing was observed on the left side of his back. Sural nerve biopsy revealed marked thickening of the perineurium with vascularization, and no necrotizing vasculitis. The pathological features of the nerve biopsy were compatible with sensory perineuritis. A biopsy from his skin lesion revealed Bowen's disease. There have been several reported cases of sensory perineuritis accompanied by malignant tumors. In these cases, immune dysfunctions were considered a common underlying cause in both diseases. This is the first reported case of sensory perineuritis associated with Bowen's disease.

Bowen's Disease↗
PubMed2005

[Therapeutic options for epithelial skin tumors. Actinic keratoses, Bowen disease, squamous cell carcinoma, and basal cell carcinoma].

There has been worldwide a significant rise in the incidence of epithelial skin tumors and their precursors in the past years with an increased number of younger patients affected. The risk factors are identified. The choice of the appropriate treatment for each individual is crucial. Major consideration include high cure rate, low long-term recurrence rate and few side effects. In the following article different therapeutic approaches for actinic keratoses, Bowen's disease, basal cell carcinoma and squamous cell carcinoma are presented and analysed.

Antineoplastic Agents↗
PubMed2001

[Perianal precancerous conditions (Bowen disease, Paget disease, Carcinoma in situ, Buschke-Lowenstein tumor)].

Perianal premalignant lesions are rare. Any suspicious perianal lesion or any perianal exanthema, that does not heal by non-surgical treatment has to be biopsied for histology. Many premalignant lesions are diagnosed as an incidental finding after anorectal surgery: any anorectal specimen must be examined by the pathologist. Leukoplakia is a facultative premalignant condition. High-grade anal intraepithelial neoplasia (AIN) is an in situ squamous cell carcinoma, associated with papillomavirus infection. Bowen's disease and Bowenoid papulosis are clinical variations of high-grade AIN. Buschke-Löwenstein tumour (giant condyloma) is a locally destructive tumour, that does not infiltrate or cause metastases. Paget's disease is a premalignant lesion like AIN, associated with other malignancies.

Anal Canal↗
PubMed2006

Bowen disease.

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