Byline: Maria. Montesu, Giuliana. Onnis, Amelia. Lissia, Rosanna. Satta, Bianca. Are, Andrea. Piana, Giovanni. Sotgiu
Sir,
Bowen's disease (BD) is an in situ squamous cell carcinoma (SCC) that may occur with multiple lesions in 10%–20% of cases.[sup][1] Furthermore, histological pagetoid cells type has been reported only in 5% of skin BD biopsy.
We describe a case of a 67-year-old male with multiple erythematous, hyperkeratotic, and ulcerated lesions that occurred 10 years before patient's observation, increasing in size and number over the years. Particularly, the widest lesion is hyperkeratotic and exudative plaque on the trunk, focal ulcerated, sized 11 cm x 8 cm [Figure 1]. Other lesions were observed on the trunk and ears. However, human papillomavirus (HPV)-related lesions were never detected on genitalia and the patient denied chronic ultraviolet and arsenic exposure.{Figure 1}
Biopsies from five lesions showed full-thickness epidermis involvement, atypical keratinocytes with large hyperchromatic and pleomorphic nuclei. Several keratinocytes presented vacuolated appearance and perinuclear halo [Figure 2],[Figure 3],[Figure 4]. Immunohistochemical staining showed...