Detecting Bowen’s Disease Through Dermoscopy
Bowen’s disease (BD), which often presents as a pink to brown scaly patch, can be difficult to distinguish from other skin diseases such as basal cell carcinoma, seborrheic keratosis, or even eczema. Because BD can develop into invasive squamous cell carcinoma, early detection is critical.
Dermoscopy has enhanced diagnostic accuracy of various skin tumors, and several studies have identified key dermoscopic features of BD: glomerular vessels, scaly surface, small brown globules, and structureless grey to brown pigmentation. However, other skin diseases share many of the features. A recent study sought to further study the dermoscopic features of BD to aid in differentiating BD from other skin diseases.
In this study, 146 cases with a histopathological diagnosis of BD were included, and the dermoscopic features of BD were described. Overall, the dermoscopic criteria most frequently observed in BD were scales, glomerular vessels, yellow crusts, focal hemorrhage, focal/multifocal hypopigmentation, linear irregular vessels, clusters of brown structureless areas, periphery radial streaks, and double-edge sign.
Two of those features are new to BD: the double-edge sign, characterized by two parallel pigmented edges at the periphery of the lesion, and clusters of brown structureless areas, characterized by several aggregated large pigmented massive structures, often distributed at the periphery of the lesion. In addition, periphery radial streaks, focal/multifocal hypopigmentation and cotton candy sign (all present in this case report) are rarely reported in other diseases and relatively specific for BD.
The authors note that while it is difficult to define a dermoscopic algorithm for BD, understanding the specific dermoscopic features of BD will facilitate the differentiation from other skin diseases.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: October 23, 2017
Source: Wiley Online
Adapted from the original article.
[Image: DermNet New Zealand]