Bowen’s disease on the palm: A case report

Abstract

BACKGROUND

Bowen’s disease (BD) is a persistent, progressive intraepidermal carcinoma. BD usually occurs in areas exposed to sunlight. Involvement of the dorsum of the hand is not rare, but that of the palmar aspect is very unusual. Only a few cases have been reported in the literature.

CASE SUMMARY

Here, we report the case of a 48-year-old male patient who presented with a history of persistent local erythema lasting for 2 years on the thenar eminence of the left palm. Initially diagnosed as hand eczema, the condition did not improve with intermittent treatment with anti-allergy medications or topical glucocorticoid ointments, among other approaches. Then, the area of erythema gradually enlarged and was accompanied by mild itching. For a definite diagnosis and treatment, the patient came to our hospital. Dermoscopic examination revealed BD, and histopathological examination confirmed the diagnosis. We performed partial resection of the skin lesion followed by photodynamic therapy. No recurrence was observed at the 6-mo follow-up.

CONCLUSION

For all atypical palmar lesions, early dermoscopy and/or skin biopsy are needed to avoid missed diagnosis or misdiagnosis.

Keywords: Bowen’s disease; Dermoscopy; Pathology; Case report

Core tip: The palm is a rare site for Bowen’s disease (BD). Local erythema and scaly skin are the first symptoms, which are easily misdiagnosed. We report a case of BD on the left palm that may have been induced by physical stimulation. Dermoscopy had a specific diagnostic performance, and skin biopsy further confirmed the diagnosis. In this case, there was no local recurrence after surgical resection and photodynamic therapy (PDT). Surgery combined with PDT can be used as an effective strategy for treating BD. Dermoscopy can be used as a routine examination for the diagnosis of chronic erythemato-squamous diseases.