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Bowenoid papulosis - Anogenital in
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Bowenoid papulosis - Anogenital in

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Contributors: Precious Cebisile Sibisi MBChB, FCDerm, MMed, Anisa Mosam MBChB, MMed, FCDerm, PhD, Ncoza C. Dlova MBChB, FCDerm, PhD, Susan Burgin MD
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Bowenoid papulosis (BP) is a clinical variant of a low-grade squamous cell carcinoma in situ (SCCIS) caused by the human papillomavirus (HPV), usually subtype 16, although other subtypes may occur. Smoking, early sexual initiation, multiple sexual partners, uncircumcised male sexual partners, and immunosuppression are contributory factors.

BP typically occurs in young sexually active adults. There is an equal male-to-female ratio. Lesions are usually asymptomatic and occur primarily in the genital and perianal region.

BP has a variable course, with a frequent potential for spontaneous regression as well as persistence and recurrence. A postsurgical excision recurrence rate of up to 20.3% has also been documented.

The risk of progression to invasive SCC in immunocompetent patients is estimated at 2.6%. In immunocompromised patients, the risk of invasive malignancy may be higher; one-half of HIV-infected patients with anogenital warts have SCCIS on histology.


D04.9 – Carcinoma in situ of skin, unspecified

402913004 – Bowenoid papulosis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • The lesions of BP are often mistaken for Genital wart, Lichen planus, and Psoriasis.
  • Unlike Squamous cell carcinoma in situ and Erythroplasia of Queyrat, which are seen in elderly patients, BP is often is seen in younger patients.
  • In contrast to BP, the lesions of Seborrheic keratosis occur in elderly patients and are rarely seen on the glans.
  • Lichen nitidus
  • Molluscum contagiosum
  • Fordyce spots
  • Lichen simplex chronicus
  • Cutaneous squamous cell carcinoma
  • Melanoma
  • Nodular basal cell carcinoma
  • Scabies
  • Fordyce angiokeratoma of scrotum
  • Syringoma
  • Secondary syphilis
  • Granular cell tumor
  • Darier disease
  • Hailey-Hailey disease
  • Papular acantholytic dermatosis

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Last Reviewed:08/11/2019
Last Updated:02/18/2020
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Bowenoid papulosis - Anogenital in
See also in: Overview
A medical illustration showing key findings of Bowenoid papulosis : Labia majora, Penis, Scrotum, Verrucous scaly papule, Multiple sexual partners
Clinical image of Bowenoid papulosis - imageId=443761. Click to open in gallery.  caption: 'Skin-colored, flat-topped verrucous papules on the penis.'
Skin-colored, flat-topped verrucous papules on the penis.
Copyright © 2024 VisualDx®. All rights reserved.