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Bowen's disease with features resembling myrmecia wart
Chao-Kai Hsu1, Yu-Chia Chen, Wei-Li Yang
1Department of Dermatology, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan; Institute of Clinical Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan; International Research Center of Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan.
Two Bowen's disease cases showed unique "myrmecioid" features mimicking warts. Human papillomavirus (HPV) was not detected, suggesting alternative pathogenic pathways for this rare skin condition.
Area of Science:
- Dermatopathology
- Oncology
Background:
- Bowen's disease (BD) is a form of squamous cell carcinoma in situ.
- Myrmecia warts are characterized by specific cytopathic effects of human papillomavirus (HPV).
Observation:
- Two cases of BD presented with clinical and pathological features resembling myrmecia warts.
- Microscopic examination revealed atypical keratinocyte proliferation and eosinophilic/basophilic inclusion bodies.
- Electron microscopy showed intranuclear and cytoplasmic electron-dense bodies resembling myrmecia inclusions.
Findings:
- Despite extensive testing (immunohistochemistry, genotyping, PCR, electron microscopy), no evidence of HPV infection was found.
- P16(INK4a) overexpression was observed in atypical keratinocytes.
- These findings challenge the direct role of detectable HPV in these specific BD cases.
Implications:
- The pathogenesis may involve unknown or undetectable HPV types or HPV-independent disruptions of the Rb signaling pathway.
- These cases suggest a potential new variant of Bowen's disease with unique "myrmecioid" clinicopathological characteristics.
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