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Evaluation of acetowhitening in Bowen's disease
1Department of Dermatology, Baylor College of Medicine, Houston, TX 77030.
Background:
From a clinical standpoint, the lesions of Bowen's disease (squamous cell carcinoma in situ) are generally sharply demarcated. Following excision, however, contiguous extension and/or small foci of Bowen's disease are occasionally found, located outside the clinically apparent margins. Acetowhitening has been suggested as a means of delineating the extent of involvement and identifying subclinical lesions of condyloma acuminata. More recently, acetowhitening has offn similarly reported to be of potential value in the presurgical evaluation of Bowen's disease.
Objective:
The purpose of this investigation was to further evaluate the use and reliability of acetowhitening both to delineate margins of Bowen's disease and to identify subclinical foci of involvement.
Methods:
Eight patients with histologically confirmed Bowen's disease were studied. Six percent acetic acid was applied to the lesions and the surrounding skin. Histologic examination of acetowhite lesions and adjacent acetowhite skin as well as adjacent, nonwhitened normal appearing skin was performed.
Results:
Our results were inconsistent, and included both false positives and false negatives.
Conclusions:
Acetowhitening is unreliable in identification of Bowen's disease. Clinically normal, acetowhite-negative skin adjacent to a lesion of Bowen's disease may be involved.