A new article published in Annals of Dermatology reported on an 85-year-old woman presented with an erythematous scaly patch on her left cheek. The lesion first appeared five years back. The patient’s medical history was insignificant.

Biopsy of the specimen exhibited – parakeratosis with crust formation in the horny layer; full epidermal thickness atypical keratinocytes; nests of pagetoid cells with vacuolated; pale cytoplasm; and mitotic figures in the epidermis. The atypical cells were positive for CK7 and negative for HER2 (CerbB2), HMB-45 and Melan-A. The diagnosis was extramammary Paget′s disease (EMPD).

Additional immunohistochemical stains depicted that the neoplastic cells were positive for p63 and negative for CK20 and Mucicarmine. Thus, the diagnosis of pagetoid Bowen′s disease was established. The patient was treated with cryotherapy once a month for six months and thereafter an apparent improvement was recorded.

About 5% of Bowen′s disease patients present with a pagetoid growth pattern with atypical keratinocytes arranged singly and in nests.

Source: Annals of Dermatology. 2021 Oct;33(5):470-472. English. 2021. doi: 10.5021/ad.2021.33.5.470