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October 1994

Anogenital Flat Papules

Author Affiliations

University of Pretoria, Republic of South Africa

Arch Dermatol. 1994;130(10):1311-1312. doi:10.1001/archderm.1994.01690100097017

REPORT OF A CASE  A 19-year-old woman presented with a 1-year history of genital and perianal lesions. Physical examination revealed multiple flat papules with a velvety texture forming small plaques in the perivulvar and perianal areas (Figure 1 and Figure 2). On colposcopic examination of the cervix, white plaquelike lesions were present at 12 o'clock. A biopsy specimen of the perivulvar lesion (Figure 3, left) showed hylularratosis with parakeratosis and papillomatosis. Cellular atypia was marked in the acanthotic epidermis with several cells showing abnormal mitoses (Figure 3, right). In a biopsy specimen from the cervix, many atypical cells and koilocytes were seen (Figure 4).What is your diagnosis?Figure 1.Figure 2.Figure 3.Figure 4.

DIAGNOSIS:  Bowenoid papulosis of the genitalia.

DISCUSSION  Immunohistochemical staining with human papillomavirus (HPV) group-specific antigen was positive in both the perivulvar and cervical biopsy specimens. Hybridization studies demonstrated HPV type 16 DNA in the

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