Laboratory Studies
Select a typical bowenoid papulosis lesion for cutaneous biopsy, and send it for routine histologic evaluation. White vinegar (5% acetic acid) application may make subclinical bowenoid papulosis lesions visible within 5-10 minutes.
Other Tests
HPV subtyping is not performed routinely in bowenoid papulosis. If subtyping the lesion is considered necessary, this can be accomplished via Southern blot hybridization, dot blot hybridization, reverse blot hybridization, or polymerase chain reaction.
Histologic Findings
Histopathologic findings with routine hematoxylin and eosin stain in bowenoid papulosis vary from those of a genital wart with buckshot atypica to full-thickness epidermal atypia. Note the images below. This is characterized by a circumscribed epidermal proliferation composed of pleomorphic cells with clumped nuclei and numerous occasionally abnormal mitoses. The integrity of the dermoepidermal border is preserved. The pattern occasionally has been described as windblown and may be identical to Bowen disease or squamous cell carcinoma in situ, occurring on nongenital skin.
Bowenoid papulosa histopathology (hematoxylin and eosin, magnification 40X).
Bowenoid papulosa histopathology (hematoxylin and eosin, magnification 400X). Johnson TM, Saluja A, Fader D, et al. Isolated extragenital bowenoid papulosis of the neck. J Am Acad Dermatol. Nov 1999;41(5 Pt 2):867-70. [Medline].
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