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February 1978

Macular Bowen's Disease

Author Affiliations

From the Department of Dermatology, University of Oklahoma Health Sciences Center and Veterans' Administration Hospital, Oklahoma City.

Arch Dermatol. 1978;114(2):282. doi:10.1001/archderm.1978.01640140092026

I n the major textbooks, it is rarely indicated that Bowen's disease may be anything but a scaly or crusted plaque, which implies an elevated lesion. Diseases listed in differential diagnoses are seldom those that may be macular. Also, little is said about what difference might exist between early and long-standing lesions.1-11 We report early, macular Bowen's disease in order to emphasize an apparently unusual clinical presentation.

Report of a Case  A 30-year-old man had a lesion cf three months' duration on the right index finger. Further history disclosed no symptoms nor any other disease, except for a recurrent verruca plantaris. There was no history of exposure to arsenic. The patient was a hospital executive of medium complexion, with little actinic damage. On the dorsum of the finger was an 8- by 9-mm, sharply defined, erythematous macule (Fig 1).Histological examination showed that the tissue had been sectioned diagonally,