Bowenoid papulosis is a rare form of intraepithelial neoplasia. This means that it is a precancerous skin condition. It occurs as single or multiple small, red, brown, or flesh-colored spots, or as spots on the male and female genitalia. It is a type of vulvar intraepithelial neoplasia (VIN) in women and a type of penile intraepithelial neoplasia in men.
The human papillomavirus (HPV), which causes genital warts and some genital cancers, is closely related to bovine papulosis. Although most cases of bovine papulosis are benign (benign), a small percentage can develop into invasive squamous cell carcinoma (cancer of the penis or vulvar).
It is a type of skin cancer that affects the epidermis. Another name for this is squamous cell carcinoma. "In situ" means that the cancer "sits" in the top layer and does not spread deeply.
It usually affects white people over the age of 60. Men understand it more than women.
Bowenoid Papulosis is described as a ‘mostly’ benign condition affecting the skin of the genitalia. Its presence is manifested in the form of small-sized multiple fleshy lesions; solitary lesions may be observed in some cases
Between 2-6% of Bowenoid Papulosis cases are associated with malignancy. Some studies inform that an invasive carcinoma can develop in approximately 2.5% of the patients
Bowenoid Papulosis is an uncommon skin condition; young adult males have a high risk for it. A close association with human papilloma virus (HPV) infection is noted
The cause of Bowenoid Papulosis is unknown, but it is influenced by factors such as infection by HPV, poor immunity, high-risk sexual practices, etc.
Symptoms
Bowenoid papulosis is a rare sexually transmitted infection with common lesions on the genitals. These injuries can last from two weeks to several years. Women can be affected within the vagina, vagina, groin folds, labia majora, labia minora, and / or anus. Men have an effect on the eyes, shaft and / or foreskin of the penis and anus. The lesions found in bovine papulosis are usually reddish-brown or purple in color, small, solid, smooth, raised, and velvety. The wounds of females are usually darker than those of males.
Most bovine papulosis patients have other types of viral infections prior to this condition. Herpes simplex, human papillomavirus, viral pimples, and HIV infection have been found in some patients with this disorder. The tissue structure of bowenoid papulosis resembles preinvasive squamous cell carcinoma (form of cancer cells) when viewed under a microscope. In some cases, bovine papulosis can be fatal.
Bowenoid papulosis disappears suddenly in several months and if a young woman is pregnant it disappears after delivery. This is an indication for active treatment, as it can lead to skin cancer if it persists.
Once infected with HPV, you can become a lifelong carrier of the virus and recurrent bovine papulosis or other intraepithelial cancers in the genital area.
Causes
Bowenoid papulosis is caused by HPV (human papillomavirus), which can also cause genital warts and cervical cancer. US. This virus is a sexually transmitted infection. Sexually active people under the age of 30 are at higher risk of contracting it, as most of the time it passes from skin to skin through contact.
Scientists are not sure what causes other forms of Bowen's disease. However, prolonged exposure to the sun and aging can increase your chances of getting many skin cancers.
Arsenic poisoning can also give you an early form of skin cancer.
What are the Risk Factors for Bowenoid Papulosis?
Sexually active people are at increased risk for bovine papulosis. As with genital warts, HPV transmission most often passes from skin to skin through sexual contact. Patients with bovine papulosis should be screened for other forms of intraepithelial neoplasia (cervical, penile, vulvar, and anal).
Men and women are at the same risk and have the highest incidence in sexually active people under 30 years of age.
The following factors increase the risk for Bowenoid Papulosis:
Infection with human papillomavirus (HPV); subtypes 16, 18, 33, 35, and 39 have been implicated
High-risk sexual behavior; sexual promiscuity
Weakened immune system as a result of HIV infection or AIDS, or due to administration of immunosuppressants
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
Diagnosis
Bowenoid papulosis can be diagnosed by its simple clinical manifestations, especially with the help of dermoscopy or skin biopsy. Diagnosis of in situ pathology by skin biopsy for squamous cell carcinoma.
You can't always tell just by looking at your skin if you have Bowen's disease. Many other skin conditions look the same.
It is confused with malignant disorders such as rash or eczema, as well as melanoma. Your doctor will usually take a biopsy of your skin.
Treatment
Bowenoid papulosis spreads to the deeper layers of your skin. Your doctor (a dermatologist who specializes in skin care and treatment) will likely call this surgical excision. They gently remove the cancerous area and cut a quarter inch beyond.
If you have a large patch, you will need a more detailed procedure called Mohs Surgery. The thin layer of tissue is removed and viewed under a microscope. If cancer cells are found on the outer edges of the tissue, another thin layer is removed and studied. When the cancer cells were not found, the surgery ended.
Besides surgery, other treatment options include:
Curatare and electrodissection: You are given a sedative injection to numb the area, and your doctor removes the patches with a special tool. They then use a high-frequency electrical current to stop the bleeding. If there are still cancer cells in the deep tissue, they will repeat this process.
Fluorocillin: This is a medicine that is put on the skin. This prevents abnormal cells from growing and reproducing. It can cause redness, pain, or itching after 1 to 2 weeks, but usually goes away in a month or two.
Imiquimode: It is also a drug that is placed on the skin. Doctors aren't sure how it works against cancer, but when used to treat acne, your immune system can help fight the virus that causes it.
Liquid Nitrogen Cryosurgery - Your doctor will spray liquid nitrogen on the affected area to freeze it. Later, depending on the amount used, the area may peel, blister, or itch.
Laser removal: Your doctor uses light energy (photons) to burn the area.
Photodynamic ("light") treatment - Uses ultraviolet rays to heal your skin. Sometimes you can apply medicine to the skin to make the cells more sensitive to light.
Radiation therapy: A type that uses very small electrically charged cells (electrons) to attack and destroy cancer cells. This type of radiation only penetrates the layers of the skin, so deep tissues and organs are safe.
If you have Bowen disease, you are at higher risk for other types of skin cancer, especially if you have a weakened immune system from the disease or medical treatments. You should carry out regular checkups and skin checks with your dermatologist
What are the possible Complications of Bowenoid Papulosis?
The complications of Bowenoid Papulosis could include:
- Cosmetic concerns in the individuals
- Discomfort in having sex
- Development of cancer: A malignant transformation is observed in approximately 1 in 40 individuals with Bowenoid Papulosis
How can Bowenoid Papulosis be Prevented?
Some of the following measures may help in the prevention of Bowenoid Papulosis:
- Using condoms, avoiding multiple sexual partners, and taking other steps to avoid sexually-transmitted infections
- Undertake immediate treatment of ulcers in the genital region
- Avoidance of smoking
- Availing vaccinations against the human papilloma virus (HPV)
- Maintaining personal hygiene