Multiple Bowen's disease due to long-term narrow-band ultraviolet B phototherapy: A case report and literature review.

OBJECTIVE: By presenting a case study on multiple instances of Bowen's disease and the consistent use of narrow-band ultraviolet B (NB-UVB) phototherapy over a three-year period, our aim is to enhance the comprehension of domestic clinicians regarding the disease. Additionally, we seek to review existing literature, encouraging dermatologists to consider clinical secondary primary lesion diagnoses. METHOD: Our approach involves analyzing a diagnosed case of multiple Bowen's disease, examining clinical manifestations, histopathology, imaging results, and treatment methods related to NB-UVB phototherapy. We aim to facilitate discussion and understanding through a comprehensive literature analysis. RESULTS: An elderly male with a 30-year history of psoriasis vulgaris initiated continuous NB-UVB therapy three years ago. A year later, he developed red patches and plaques with distinct borders and scaly surfaces on his face, trunk, lower extremities, and scrotum. Histopathological examination confirmed Bowen's disease. Treatment involved liquid nitrogen cryotherapy, with no recurrence observed during the one-year follow-up. CONCLUSION: This case highlights that Bowen's disease, typically solitary, can manifest as multiple instances, especially in individuals with a history of psoriasis vulgaris. While NB-UVB stands as the primary treatment for psoriasis vulgaris, caution is warranted due to the potential risk of skin tumor induction with prolonged high-dose usage. Clinicians should be vigilant in monitoring and assessing the long-term implications of such therapies.

Clearance of human papillomavirus related anal condylomas after oral and endorectal multistrain probiotic supplementation in an HIV positive male: A case report.

INTRODUCTION: Here we present the case of a 56-year-old human immunodeficiency virus (HIV)-infected man with multiple anal condylomas and positivity for human papilloma virus (HPV) 18 on anal brushing. Biopsies of the anal mucosa led to the diagnosis of Bowen's disease and a subsequent pelvic magnetic resonance imaging (MRI) scan evidenced multiple reactive lymphoadenopathies and large intra-anal condylomas. The patient was treated with a complete excision of Bowen's lesion and with a 4 months course of supplementation with a high concentration multistrain probiotic formulation administered orally and by rectal instillation with the purpose to reduce local inflammation and to enhance local mucosal immunity. CONCLUSION: An MRI performed at the end of the supplementation period evidenced the clearance of the anal condylomas previously described and no evidence of residual lymphadenopathies. Trials are therefore required to confirm this therapeutic possibility and for a better understanding of the mechanisms by which this specific probiotic formulation interacts with local epithelium when administered by the anal route.

Podophyllin reaction mimicking Bowen's disease in a patient with delusions of verrucosis.

A 40-year-old woman presented with a delusion of warts on the forehead, for which she was applying podophyllin toxin. A skin biopsy was taken, which showed prominent mitotic figures in the basal and suprabasal layers of the epidermis and apoptotic keratinocytes. Histopathologically Bowen's disease was suspected, but was discounted after clinicopathological correlation was obtained and showed absence of epidermal atypia or disorganization. This case demonstrates the histological resemblance of podophyllin reaction to Bowen's disease. Differentiation of self-inflicted from organic skin disease may be difficult, especially where histopathological findings are confounded by cutaneous application of toxins.

[Cutaneous neoplasms]. / Neoplasien der Haut.

The skin is the organ most commonly affected by malignancies. Various cancers of the skin show a dramatic increase in incidence over the last decades. Epithelial skin tumors are most frequently, e.g., basal cell carcinoma and the squamous cell carcinoma with its precursors, the actinic keratoses. Melanoma, which is extremely difficult to treat in advanced tumor stages, is dreaded. Besides that, there are other epithelial malignant diseases, e.g. Morbus Bowen and adnexal tumors originating from the skin appendices. Mesenchymal malignant neoplasias such as Morbus Kaposi, angiosarcomas and other dermal sarcomas, are rare. Since the majority of malignant neoplasms is removable and curable by a simple surgical intervention, the knowledge of the different skin tumors is essential for non-dermatologist.

Hyperthermic treatment of Bowen's disease with disposable chemical pocket warmers: a report of 8 cases.

Bowen's disease is a form of squamous cell carcinoma in situ, in which local hyperthermia may be efficacious. We studied 8 patients with Bowen's disease to ascertain whether hyperthermia can be effective against it. As a heat source, disposable chemical pocket warmers were applied daily with pressure directly to the lesion site while the patient was awake, and the clinical course was observed for 4 to 5 months. The lesion was then excised and examined to determine the histopathologic effects. The results showed efficacy in 6 cases, in which the nodular and invasive lesions and the erythematous patches abated; then the lesions disappeared, leaving deposits of pigment (complete remission). In one case, the signs improved by at least 50% (partial remission); in the other case, there was only slight palliation (no response). As for the posttreatment histopathologic effects, tumor cells were eliminated in 3 cases, isolated tumor cells were seen in 3 cases, and there was no change in 2. Although the treatment did not yield perfect results, it represents a major improvement of hyperthermic therapy and is one effective method of treating Bowen's disease.

Validez del diagnóstico de carcinoma epidermoide / Validity of clinical diagnosis of squamous cell carcinoma

Objetivo: Evaluar la validez del diagnóstico clínico de carcinoma epidermoide. Material y métodos: Estudio descriptivo transversal. Se estudió a un grupo de pacientes diagnosticados histopatológicamente de carcinoma epidermoide o de cualquiera de sus diagnósticos diferenciales más frecuentes. Se hizo una estimación muestral con una sensibilidad y una especificidad del 85 por ciento, una precisión del 5 por ciento y una confianza del 95 por ciento, estimándose necesarios 394 casos. Se compararon los diagnósticos anatomopatológicos (patrón oro) con los diagnósticos clínicos. Se estudió la sensibilidad, especificidad, valores predictivos, cocientes de probabilidad y valor global. Resultados: Se incluyeron 394 pacientes, 197 con carcinoma epidermoide y 197 con sus diagnósticos diferenciales. La localización más frecuente del carcinoma epidermoide fue la cara. Se obtuvo una sensibilidad del 64,5 por ciento (IC95 por ciento del 57,8 por ciento al 71,2 por ciento), una especificidad del 94,4 por ciento (IC95 por ciento del 92,8 por ciento al 96,0 por ciento), un valor global del 79,4 por ciento (IC95 por ciento del 76,6 por ciento al 82,2 por ciento), un valor predictivo positivo del 92,0 por ciento (IC95 por ciento del 90,1 por ciento al 93,9 por ciento) y un valor predictivo negativo del 72,7 por ciento (IC95 por ciento del 69,5 por ciento al 75,9 por ciento). Conclusiones: Se obtuvieron una validez diagnóstica alta. La evaluación del diagnóstico en patologías con una prueba diagnóstica patrón oro (gold standard), como es la histopatología, permite objetivar la validez del diagnóstico clínico (AU)

[The radiophosphorus (32P)-test in precanceroses and malignant tumors of the skin]. / Radiophosphor (32P)-Test bei Präkanzerosen und malignen Tumoren der Haut

In 21 patients with a variety of skin tumors (squamous cell carcinomas, malignant melanomas, basal cell epitheliomas and mycosis fungoides) or pre-cancerous lesions (Bowen's disease, actinic keratosis, junctional nevus cell nevus) the radioactive phosphorus uptake test demonstrates a significantly increased concentration of P32 in those tumors. There were no false negative tests. The possibility of differentiation of malignant melanoma from benign nevus cell nevus and the early recognition of cutaneous metastases is described. Furthermore recurrence of previously irradiated or excised basal cell epitheliomas can be detected without a biopsy. No hematological side-effects were observed.