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

Bowen's disease (BD) is an in situ squamous cell carcinoma of the epidermis with multiple etiologies and a high incidence among Caucasians. It commonly occurs in photo-exposed areas of the skin, although other sites can also be affected. Most lesions are solitary, and their morphology can vary based on the lesion's age, origin, and degree of keratinization. A 50-year-old female from Saudi Arabia presented to the dermatology clinic with a three-year history of slowly enlarging skin lesions on the left side of her chest. Initially, the lesion appeared three years ago, but she observed changes and a darkening in color over the past year, accompanied by mild pain and itching. On examination, the lesion was a 2 × 2 cm, well-defined, unevenly pigmented brown-black plaque with a dispersed pigment pattern and irregular borders with globularity on the left side of the upper chest. A 4 mm punch biopsy was taken from the most pigmented area and sent for histopathological examination, which confirmed the diagnosis of pigmented BD.