Acantholytic variant of bowen′s disease with micro-invasive squamous cell carcinoma: A case report of a unique variant

Abstract

Bowen's disease is generally regarded as premalignant dermatoses. The disease affects both skin and the mucosa and has the potential to progress to invasive squamous cell carcinoma. There are descriptions of several histological variants of Bowen's disease like psoriasiform, atrophic, pagetoid, etc. Acantholysis of anaplastic keratinocytes with bullae/cleft formation is described in premalignant condition like actinic keratosis and adenoid variant of squamous cell carcinoma, but there is lack of report describing this phenomena in Bowen's disease. We present a case of unusual acantholytic variant of Bowen's disease with focus of micro-invasive carcinoma.

Shedding new light on actinic keratoses and squamous cell carcinoma in situ

“…17 The acantholytic variant demonstrates acantholysis in a thickened epidermis with a pagetoid pattern. 29 The epidermolytic variant demonstrates epidermolytic hyperkeratosis. 19 The clear cell variant has been associated with HPV infection.…”

Bowen's disease

“…[ 77 ] The cells of the upper dermis occasionally undergo vacuolization with abundant and strong eosinophilic cytoplasm. [ 76 ] The secondary amyloid deposition is a known fact in BD and it might herald the regression of tumor. The BD have been described to be associated with sebaceous or mucinous metaplasia.…”

“…[ 19 ] The histopathological differential diagnoses of BD are mentioned in Table 3 . [ 1 2 14 58 72 76 75 78 80 81 82 83 84 ]…”

Palmar lokalisierter HPV16-positiver Morbus Bowen

“…Als Risikofaktoren für die Entstehung dieses Tumors gelten v. a. die UV-Strahlung über längere Zeiträume und chemische Karzinogene (wie z. B. Arsen), sowie humane Papillomaviren (es wurden folgende HPV-Typen schon beschrieben: 1, 2, 4, 5,6,11,15,16,20,25,34,35,38). Das Auftreten dieses Tumors ist am gesamten Integument möglich, v. a. an lichtexponierten Hautarealen (wie Gesicht und Hände) und kommt viel häufiger bei älteren Patienten vor [11].…”