Squamous cell carcinoma in situ / Bowens disease
From dermoscopedia
Non-pigmented Bowen’s disease
Bowen’s disease represents an intraepithelial carcinoma or in situ Squamous cell carcinoma (SCC). The most frequent clinical presentation is an erythematous scaly patch or slightly elevated plaque.
The archetypal dermoscopic pattern of BD is characterized by two types of vascular patterns:
- Clustered vascular pattern: Focal, clustered, asymmetric distribution of the vessels
- Glomerular (coiled) vessels: Tortuous capillaries, which are larger than dotted vessels and are often distributed in clusters mimicking the glomerular apparatus of the kidney.
The concurrent presence of hyperkeratosis (surface scale) allows a high diagnostic probability.
Figure: Bowen's disease with glomerular vessels and scales.
Pigmented Bowen’s disease
Pigmented Bowen’s disease (pBD) is more frequently described in darker skin phenotypes.
The following dermoscopic criteria are suggested to be a specific clue for the diagnosis of pBD:
- Brown or grey dots: these dots are a strong clue when arranged as linear radial lines at the periphery of the lesion
- Pink or skin colored eccentric structureless areas
- Glomerular (coiled) vessels, arranged randomly, as clusters, or in radial lines
References
- An Atlas of Dermoscopy, Second Edition. Marghoob A. et al. CRC Press; 2012.
- Bugatti, L., Filosa, G. & De Angelis, R., 2004, Dermoscopic observation of Bowen’s disease. J Eur Acad Dermatol Venereol, 18, 572–4.
- Bugatti, L., Filosa, G. & De Angelis, R., 2007, The specific dermoscopical criteria of Bowen’s disease. J Eur Acad Dermatol Venereol, 21, 700–1.
- Cameron A., Rosendahl C., Tschandl P., Riedl E., Kittler H., 2010, Dermatoscopy of pigmented Bowen’s disease. J Am Acad Dermatol, 62, 597–604.
- Stante, M., De Giorgi, V., Massi, D., Chiarugi, A. & Carli, P., 2004, Pigmented Bowen’s disease mimicking cutaneous melanoma: clinical and dermoscopic aspects. Dermatol Surg, 30, 541–4.
- Zalaudek, I. & Argenziano, G., 2004, Glomerular vessels in Bowen’s disease. Br J Dermatol, 151, 720.
- Zalaudek, I., Argenziano, G., Leinweber, B., et al., 2004, Dermoscopy of Bowen’s disease. Br J Dermatol, 150, 1112–16.
- Zalaudek, I., Di Stefani, A. & Argenziano, G., 2006a, The specific dermoscopic criteria of Bowen’s disease. J Eur Acad Dermatol Venereol, 20, 361–2.
