Topical steroid application can induce branched/reticular vessels in Bowen disease on the upper trunk
https://doi.org/10.4081/dr.2020.8835
Accepted: 15 September 2020
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We aimed to elucidate the dermoscopic vasculature of patients with Bowen Disease (BD) that was misdiagnosed as chronic eczema and had branched and/or reticular vessels after topical steroid application. The medical records of 19 patients with BD on the upper trunk were retrospectively reviewed for steroid use history, vascular structure observed in dermoscopy, and corresponding histological findings. Four patients treated with strong topical steroids showed remarkable branched and/or reticular vessels on dermoscopy. Histopathology showed partial epidermal atrophy with irregular thin elongation of the rete ridges, atypical keratinocyte proliferation in the epidermis, and vasodilation in the superficial dermis. We considered that vasodilation and partial epidermal atrophy may be induced by topical steroid application in BD-affected areas. In cases of suspected BD with reddish-brown plaque showing branched and/or reticulated vessels in dermoscopy, confirming a history of topical steroid use is helpful.
2. Gebhardt C, Averbeck M, Diedenhofen N, et al. Dermal hyaluronan is rapidly reduced by topical treatment with glucocorticoids. J Invest Dermatol 2010;130:141-9.
3. John BJ. Topical glucocorticoids. In: Griffiths C, Barker J, Bleiker T, et al., eds. Rook’s textbook of dermatology. 9th ed. Hoboken, NJ: Wiley-Blackwell,; 2016. pp 18.13-8.
4. Bugatti L, Filosa G, De Angelis R. Dermoscopic observation of Bowen’s disease. J Eur Acad Dermatol Venereol 2004;18:572-4.
5. Mun JH, Kim SH, Jung DS, et al. Dermoscopic features of Bowen’s disease in Asians. J Eur Acad Dermatol Venereol 2010;24:805-10.
6. Cameron A, Rosendahl C, Tschandl P, et al. Dermatoscopy of pigmented Bowen’s disease. J Am Acad Dermatol 2010;62:597-604.
7. Payapvipapong K, Tanaka M. Dermoscopic classification of Bowen’s disease. Australas J Dermatol 2015;56:32-5.
8. Yamanaka-Takaichi M, Ozawa T, Kusutani N, et al. Relationship between dermoscopy and pathology in a case of clonal-type pigmented Bowen's disease: observation with vertical-view dermoscopy. J Dermatol 2019;46:436-9.
9. Papageorgiou C, Apalla Z, Variaah G, et al. Accuracy of dermoscopic criteria for the differentiation between superficial basal cell carcinoma and Bowen’s disease. J Eur Acad Dermatol Venereol 2018;32:1914-9.
10. Nihei N, Hiruma M, Ikeda S, Ogawa H. A case of Bowen’s disease showing a clinical tendency toward spontaneous regression. J Dermatol 2004;31:569-72.
11. Yang Y, Lin J, Fang S, et al. What’s new in dermoscopy of Bowen’s disease: two new dermoscopic signs and its differential diagnosis. Int J Dermatol 2017;56:1022-5.
12. Zalaudek I, Citarella L, Soyer HP, et al. Dermoscopy features of pigmented squamous cell carcinoma: a case report. Dermatol Surg 2004;30:539-40.
13. Stante M, de Giorgi V, Massi D, et al. Pigmented Bowen’s disease mimicking cutaneous melanoma: clinical and dermoscopic aspects. Dermatol Surg 2004;30:541-4.
14. Hu SC, Chiu HH, Chen GS, et al. Dermoscopy as a diagnostic and follow-up tool for pigmented Bowen’s disease on acral region. Dermatol Surg 2008;34:1248-53.
15. Hernández-Gil J, Fernández-Pugnaire MA, Serrano-Falcón C, Serrano-Ortega S. [Clinical and dermoscopic features of pigmented Bowen disease]. Actas Dermosifiliogr 2008;99:419-20.
16. de Giorgi V, Alfaioli B, Papi F, et al Dermoscopy in pigmented squamous cell carcinoma. J Cutan Med Surg 2009;13:326-9.
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