Dermoscopic Features of Pigmented Bowen Disease in Phototype IV Patients
Keywords:
Dermoscopy, skin cancer, pigmented Bowen's Disease, skin of colorAbstract
Introduction: Research on the dermoscopic features of pigmented Bowen disease (pBD) in individuals with phototype IV skin is limited and consists primarily of case reports or small studies.
Objectives: We sought to describe the clinical and dermoscopic characteristics of 21 cases of pBD in a skin phototype IV population.
Methods: We conducted a multicenter retrospective analysis of 21 histopathologically confirmed cases of pBD under the auspices of the Dermoscopy Chapter of the Ibero-Latin American College of Dermatology (CILAD).
Results: A total of 21 pBD cases in phototype IV patients (57% male, mean age 63.1 years) were analyzed. Lesions were most frequently located on the upper extremities and head and neck area (29% and 24%, respectively) and exhibited brown (90.5%) and pink (90.5%) coloration, with a higher prevalence of gray, black, and blue compared to lighter phototypes. Structureless areas (90.5%) and pigmented dots in a linear arrangement (71.4%) were the most frequent dermoscopic findings. Non-specific dermoscopic findings were observed in 23.8% (N=5) of cases.
Conclusion: PBD in phototype IV presents with a distinct dermoscopic pattern, including a higher proportion black and blue colors and fewer vascular structures than observed in lighter phototypes. The most prominent dermoscopic findings were structureless areas and pigmented dots, either in a central or peripheral linear arrangement; however, in a quarter of the cases, no specific clue was observed. These findings emphasize the need for tailored diagnostic approaches and the importance of biopsy when specific dermoscopic features are absent.
References
Vestergaard ME, Macaskill P, Holt PE, Menzies SW. Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol. 2008 Sep;159(3):669-76. DOI: 10.1111/j.1365-2133.2008.08713.x. Epub 2008 Jul 4. PMID: 18616769.
Kittler H, Pehamberger H, Wolff K, Binder M. Diagnostic accuracy of dermoscopy. Lancet Oncol. 2002 Mar;3(3):159-65. DOI: 10.1016/s1470-2045(02)00679-4. PMID: 11902502.
Bafounta ML, Beauchet A, Aegerter P, Saiag P. Is dermoscopy (epiluminescence microscopy) useful for the diagnosis of melanoma? Results of a meta-analysis using techniques adapted to the evaluation of diagnostic tests. Arch Dermatol. 2001 Oct;137(10):1343-50. DOI: 10.1001/archderm.137.10.1343. PMID: 11594860.
Reiter O, Mimouni I, Gdalevich M, et al. The diagnostic accuracy of dermoscopy for basal cell carcinoma: A systematic review and meta-analysis. J Am Acad Dermatol. 2019;80(5):1380-1388. DOI: 10.1016/j.jaad.2018.12.026. Epub 2018 Dec 21. PMID: 30582991.
Dinnes J, Deeks JJ, Chuchu N, et al. Visual inspection and dermoscopy, alone or in combination, for diagnosing keratinocyte skin cancers in adults. Cochrane Database Syst Rev. 2018;12(12):CD011901. DOI: 10.1002/14651858.CD011901.pub2. PMID: 30521688
Zalaudek I, Argenziano G, Leinweber B et al. Dermoscopy of Bowen's disease. Br J Dermatol. 2004 Jun;150(6):1112-6. DOI: 10.1111/j.1365-2133.2004.05924.x. PMID: 15214896.
Cabo H, Salerni G, Sabban EC et al. Dermoscopic Features of Pigmented Bowen Disease: A Multicenter Study on Behalf of the Ibero-Latin American College of Dermatology (CILAD). Dermatol Pract Concept. 2024 Apr 1;14(2):e2024086. DOI: 10.5826/dpc.1402a86. PMID: 38810038
Bugatti L, Filosa G, De Angelis R. Dermoscopic observation of Bowen's disease. J Eur Acad Dermatol Venereol. 2004 Sep;18(5):572-4. DOI: 10.1111/j.1468-3083.2004.01008.x. PMID: 15324396.
Stante M, de Giorgi V, Massi D, Chiarugi A, Carli P. Pigmented Bowen's disease mimicking cutaneous melanoma: clinical and dermoscopic aspects. Dermatol Surg. 2004 Apr;30(4 Pt 1):541-4. DOI: 10.1111/j.1524-4725.2004.30173.x. PMID: 15056147.
Cameron A, Rosendahl C, Tschandl P, Riedl E, Kittler H. Dermatoscopy of pigmented Bowen's disease. J Am Acad Dermatol. 2010 Apr;62(4):597-604. DOI: 10.1016/j.jaad.2009.06.008. Epub 2010 Jan 15. PMID: 20079953.
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Copyright (c) 2026 Gabriel Salerni, Horacio Cabo, Emilia Cohen-Sabban, Sonia Rodriguez-Saá, Flavia Carolina Pozzobon, Cristian Navarrete-Dechent , Ivonne Arellano-Mendoza, Virginia Mariana Gonzalez , Renato Bakos , Nicole Orendain, Malynahi Tapia-Juarez , Luis Morales Godinez , Diana Guerrero Hernández , Sofia Andre, Susana Puig
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