By vgreene, 10 November, 2020

(BMJ)—An otherwise healthy, nonsmoking 33-yo woman presented w/ a 6-mo hx of asymptomatic lesions around her vulva. The lesions had been increasing in size and number. Exam: multiple hyperpigmented papules on labia majora and minora and perianal area. What’s the dx?
Pigmented condyloma acuminata
Bowenoid papulosis
Squamous cell carcinoma
Lichen planus
Warty dyskeratoma
You are correct. Histopathological findings, along w/ the clinical picture, confirmed the dx of bowenoid papulosis, a precancerous lesion assoc w/ HPV that’s typically benign. This pt hadn’t been vaccinated against HPV. It’s important to differentiate this condition from vulvar intraepithelial neoplasia to avoid over-tx because bowenoid papulosis can regress spontaneously or w/ conservative mgmt.

BMJ 2020;370:m2250