Bowenoid papulosis: causes, symptoms, diagnosis, treatment

Bowenoid papulosis is a combination of intraepithelial neoplasia with infection with the human papilloma virus. It is manifested by multiple eruptions in the genital area of a reddish-brownish or cyanotic color, slightly protruding above the surface of the skin, sometimes hyperpigmented. At many patients simultaneously find out warts, condylomas, a simple blistering deprive. It develops usually in adults, rarely in children. The course is usually benign, but the transformation into squamous cell carcinoma is not ruled out.

Pathomorphology of Bowenoid Papulosis. The histological pattern resembles genital warts with cytological signs of carcinoma in situ. This is confirmed by the presence in the epidermis of atypical epithelial cells, a large number of discrete cells, mitosis. There are large multinuclear epitheliocytes, pronounced hyperkeratosis and parakeratosis. In the dermis, the expansion and tortuosity of capillary vessels, inflammatory infiltrates mainly from lymphocytes are noted. However, with this disease, a greater histological variability can be observed. In some cases, atypia of epithelial cells is insignificant, in others it is sharply expressed against the background of high mitotic activity, as a result of which this disease can not be differentiated from carcinoma in situ. Electron microscopy reveals a picture similar to that of Bowen's disease, and sometimes - with genital warts. In separate foci in the nuclei of epithelial cells of the epidermis, virus-like particles 30-50 nm in diameter, similar in structure to the human papilloma virus, are found.

Histogenesis of Bowenoid Papulosis. The disease is mainly caused by the 16th and 18th types of human papillomavirus. Many patients have signs of primary immunodeficiency (not associated with HIV infection), mainly due to a decrease in the number of T-helpers.

[1], [2], [3], [4], [5], [6]