Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2019; 7(18): 2910-2915
Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2910
Bowen’s disease on the palm: A case report
Shi-Rong Yu, Jing-Zhan Zhang, Xiong-Ming Pu, Xiao-Jing Kang
Shi-Rong Yu, Jing-Zhan Zhang, Xiong-Ming Pu, Xiao-Jing Kang, Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Shi-Rong Yu, Graduate School, Xinjiang Medical University, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Author contributions: Yu SR and Zhang JZ contributed equally to this work. Yu SR designed the study; Zhang JZ and Pu XM contributed to surgical treatment and follow-up data collection, analyzed the data, and wrote the paper; Kang XJ revised the manuscript; all authors read and approved the final manuscript.
Informed consent statement: The patient provided written informed consent.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Jing Kang, MD, PhD, Chairman, Professor, Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Tianshan District, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. drkangxj666@163.com
Telephone: +86-991-8563456 Fax: +86-991-8564761
Received: May 16, 2019
Peer-review started: May 23, 2019
First decision: August 1, 2019
Revised: August 14, 2019
Accepted: August 27, 2019
Article in press: August 26, 2019
Published online: September 26, 2019
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.