Bowen's disease is an in situ squamous cell carcinoma of the skin with only 2% of
pigmented cases reported. It is clinically characterized by papules and plaques
of blackened surface that may be caused either by sun damage - usually in
photoexposed areas in elderly individuals - or by human papillomavirus infection
- usually in the anogenital region of young adults. Dermoscopic aspects of
Bowen's disease are discussed for over a decade, but with no definitive criteria
that would lead to a definitive diagnosis. We present a case of Bowen's disease
affecting the finger of a 57-year-old Asian patient. The lesion clinically and
dermoscopically simulated a melanoma. Histopathological findings suggested the
diagnosis of pigmented Bowen's disease. Pigmented Bowen's disease should be
considered a differential diagnosis of melanoma, since its clinical and
dermoscopic criteria are unspecific. Histopathological examination remains the
gold standard for the diagnosis of the disease.
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