Bowenoid Papulosis
Elsa F. Velazquez, MD
Key Facts
Etiology/Pathogenesis
Most often related to HPV 16
Clinical Issues
Often multifocal
Benign-looking papules
Usually affecting skin of shaft in males
Affecting labia majora in females
Lesions tend to be bilateral and hyperpigmented
Microscopic Pathology
Proliferation of atypical basaloid and koilocytic cells as scattered single units or involving full thickness of epithelium
Most cases are indistinguishable from SCCis
Top Differential Diagnoses
Vulvar and penile intraepithelial neoplasia (VIN and PeIN)
Treated condyloma
 Patchy foci of full thickness keratinocytic atypia are usually seen in bowenoid papulosis. Atypical cells vary from small basaloid to larger and more pleomorphic with koilocytic-like changes  . |
 Bowenoid papulosis shows atypical keratinocytes throughout the full thickness of the epithelium. There are several mitoses and koilocytic change. |
TERMINOLOGY
Abbreviations
Bowenoid papulosis (BP)
Synonyms
Multicentric pigmented Bowen disease
Definitions
Multifocal HPV-related, papular, preneoplastic condition affecting anogenital region in sexually active young adults
ETIOLOGY/PATHOGENESIS
Etiology
Related to high-risk types of HPV, especially type 16
Other types of HPV (18, 31, 32, 33, 34, 35, 39, 42, 48, 51, 52, 53, and 54) have also been implicated
Usually transmitted via sexual contact
Pathogenesis
Oncogenic HPV elaborate proteins that interfere with normal cellular homeostasis
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