Synonym(s)
bowenoid papules; Papules bowenoide; Papules multiple bowenoids of the vulva; Papules multiple bowenoids on the penis; Penis papules pigmented; Pigmented penis or vulva papules; Vulvapapules pigmented bowenoids
HistoryThis section has been translated automatically.
Head, 1977
DefinitionThis section has been translated automatically.
Benign, persistent, flat, brownish to reddish papules in the genital area caused by "high risk" human papilloma viruses (HPV type 16 or 18) with the histological picture of a M. Bowen.
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PathogenThis section has been translated automatically.
Mostly caused by HPV 16, but other "high risk" HPV types have also been described as triggers.
ManifestationThis section has been translated automatically.
Occurs mainly in men in young and middle adulthood, less frequently in women.
LocalizationThis section has been translated automatically.
Prepuce, glans penis, penis shaft, small and large labia, perineum, anal area.
Clinical featuresThis section has been translated automatically.
Usually multiple, 0.2- 0.5 cm large, flat, reddish-brown (reminiscent of lichen planus), irregularly bounded papules with mostly smooth or velvety, but occasionally also woolly, then mostly whitish tinged surface.
Anamnestically often condylomata acuminata, but rarely simultaneous occurrence.
Rarely a transition to Bowen's disease or an invasive squamous cell carcinoma has been observed after decades of persistence.
HistologyThis section has been translated automatically.
- Plump acanthosis in hyperorthokeratosis and focal parakeratosis. Good differentiation of the epithelial dressing to the depth and to the side. Clear polymorphism of the keratinocytes with numerous dyskeratoses, multinuclear keratinocytes, pynotic nuclei, giant nuclei and mitoses. No invasive growth detectable. In the dermis band-shaped lympho-histiocytic infiltrate.
- Molecular genetics: HPV detection by in situ hybridisation or PCR.
DiagnosisThis section has been translated automatically.
Clinical picture, mostly younger patients, histological examination with HPV detection.
Differential diagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
- In case of extensive infestation (> 5 papules), removal with an electric cautery and subsequent "flat" curettage with a cutting curette (Fa. Stiefel) is recommended.
- If necessary, a circumcision should be performed on the man (change in terrain conditions). Circumcision should always be attempted in the event of repeated recurrence of the bowenoid papules.
External therapyThis section has been translated automatically.
Apply Imiquimod 5% cream (Aldara) 3 times/week overnight. Therapy duration up to a maximum of 16 weeks.
ProphylaxisThis section has been translated automatically.
In a multicenter study, a quadrivalent HPV vaccine was shown to significantly reduce HPV 6, 11, 16 and 18-induced infections in young women aged 16-23 years. The vaccine is a dead vaccine. Precancerous dysplasia or genital warts have not been observed. Approval in the EU was granted at the end of 2006. At present, some statutory health insurance companies in Germany cover the costs for the treatment of young women aged 9-15 years.
LiteratureThis section has been translated automatically.
- Garland SM (2003) Imiquimod. Curr Opin Infect Dis 16: 85-89
- Gross G (2001) Clinical aspects and therapy of anogenital warts and papillomavirus-associated lesions. dermatologist 52: 6-17
- Head AW, beard RS (1977) Multiple bowenoid papules of the penis: a new entity. J Dermatol Surg Oncol 3: 265-269
- Loo W, Holt P (2003) Bowenoid papulosis successfully treated with imiquimod. J Eur Acad Dermatol Venereol 17: 363-365
- Porter WM et al (2002) Penile intraepithelial neoplasia: clinical spectrum and treatment of 35 cases. Br J Dermatol 147: 1159-1165
- Petrow W et al (2001) Successful topical immunotherapy of bowenoid papulosis with imiquimod. Br J Dermatol 145: 1022-1023
- Villa LL et al (2006) High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 virus-like particle vaccine through 5 years of follow-up. Br J Cancer 95: 1459-1466
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Incoming links (12)
Acuminate condyloma; Apoptosis; Papules bowenoide; Papules, multiple bowenoids of the vulva; Papules, multiple bowenoids on the penis; Penis papules, pigmented; Pigmented penis or vulva papules; Pin; Precanceroses in the strict sense; Reflected light microscopy, perivascular melanophages; ... Show allOutgoing links (7)
Acuminate condyloma; Bowen's disease; Circumcision; Erythroplasia queyrat; Imiquimod; Papel; Papillomavirus;Disclaimer
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
Prof. Dr. med. Peter Altmeyer
