‘Bowenoid Wart’: Wart with Bowenoid Histological Changes?

Abstract

Introduction: Cases of lesions that simulate Bowen’s disease have been previously described in the literature. Case Report: Nine exophytic verruca-like lesions with histological findings of Bowen’s disease (BD) are described. All cases had a rapid growth, and were located on the face and neck of elderly patients with chronic solar skin damage. We carried out p16 immunohistochemical staining using the immunoperoxidase technique, which was negative in all cases. Discussion: We think that these 9 lesions are only histologically mimicking BD, and could be a subtype of verruca (‘bowenoid wart’). These lesions could be provoked by nononcogenic human papillomavirus (HPV), as in other cases previously described. The p16 staining was negative in all cases, in contrast with most BD cases. It would be interesting to study whether positive p16 staining is related to oncogenic HPV, whereas negative p16 staining could be associated with low or nononcogenic HPV; thus, more studies are needed.

Combined Papillated Bowen Disease and Clear Cell Atypical Fibroxanthoma

“…Both lesions show histologic characteristics suggestive of HPV infection, but no type of HPV has been identified so far [1, 9], and p16 was negative in the 9 cases described by Corbalán-Vélez et al [9]. So the pathogenesis of PBD-BW is not clear and the possible role of HPV in the genesis of these lesions keeps on being merely a speculation.…”

“…However, the authors suggested that more sensitive procedures, as polymerase chain reaction (PCR), should be used before being sure that PBD was pathogenetically not related to HPV infection. More recently, Corbalán-Vélez et al [9] described 9 cases of bowenoid wart (BW) localized on the face, neck and temporal region. The lesions showed a verrucous growth pattern with intraepidermal bowenoid atypia and epithelial cells with koilocytic changes in the upper layers of the epidermis.…”

“…PCR for DNA of HPV was not useful probably due to problems with the samples. These authors raise the possibility that BW, versus PBD, was induced by non-oncogenic HPV as those described in warts with in situ carcinoma [10, 11] or perhaps due to a synergistic effect of some type of HPV with solar radiation [9]. …”