Giant extragenital Bowen's disease

Area of Science:

• Dermatology
• Oncology

Background:

• Giant extragenital Morbus Bowen (Bowen's disease) is exceptionally rare.
• Commonly reported localizations include periungual, foot, and neck areas.
• Clinical presentation often involves non-specific erythematous or erythematous-squamous plaques/papules, posing diagnostic challenges.

Purpose of the Study:

• To emphasize the importance of human papillomavirus (HPV) detection in giant extragenital Morbus Bowen.
• To outline therapeutic strategies based on HPV status.
• To discuss management options for HPV-negative cases.

Main Methods:

• Review of literature on giant extragenital Morbus Bowen.
• Discussion of diagnostic considerations, particularly HPV testing.
• Analysis of treatment modalities including antiviral therapy, immunomodulation, and surgical eradication.

Main Results:

• HPV status is critical for selecting appropriate treatment for Morbus Bowen.
• HPV-positive cases may respond to systemic antiviral therapy prior to surgery.
• HPV-negative cases, like the one described, warrant focus on local immunomodulation (e.g., imiquimod).

Conclusions:

• Accurate HPV detection is mandatory for guiding giant extragenital Morbus Bowen treatment.
• Therapeutic options for HPV-negative giant extragenital Morbus Bowen include imiquimod, 5-fluorouracil, photodynamic therapy, cryotherapy, and laser therapy.
• Treatment selection should be individualized based on lesion characteristics and clinician judgment.