Pigmented Bowen's Disease: A Case Report in Saudi Arabia

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Bowen's disease (BD) is an intraepidermal squamous cell carcinoma.
• It commonly affects sun-exposed skin but can occur elsewhere.
• Lesion morphology varies, and pigmented presentations are less common.

Observation:

• A 50-year-old female presented with a 3-year history of a slowly enlarging, pigmented skin lesion on her chest.
• The lesion showed changes in color, size, and texture over the past year, with associated mild pain and itching.
• Clinical examination revealed a 2x2 cm, well-defined, unevenly pigmented brown-black plaque with irregular borders.

Findings:

• Histopathological examination of a punch biopsy confirmed the diagnosis of pigmented Bowen's disease.
• The biopsy revealed features consistent with squamous cell carcinoma in situ.

Implications:

• This case underscores the importance of considering pigmented Bowen's disease in the differential diagnosis of atypical pigmented skin lesions.
• Early detection and diagnosis are crucial for effective management of squamous cell carcinoma.
• Further research may elucidate the specific factors contributing to pigmented presentations of BD.