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Pigmented Bowen’s Disease in African Males: A Two-Case Series
  • Sema-Ramashala Agnes Ramadimetja
Sema-Ramashala Agnes Ramadimetja
University of Pennsylvania Department of Dermatology

Corresponding Author:[email protected]

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Abstract

Background Non-melanoma skin cancer (NMSC) in Africans is less common than in Caucasians because of melanin, which plays a protective role against ultraviolet radiation and subsequent skin cancers. However, Bowen’s disease, a type of skin carcinoma-in-situ, occurs on both sun-exposed and sun-protected sites and if missed, may progress to invasive squamous cell carcinoma. In general, there is paucity of literature on NMSC occurring in skin of colour versus in white skin, and pigmented Bowen’s disease (PBD) is no exception. Clinicians should be able to recognise this type of cancer in black skin to avoid invasive malignancy. Case I A 68-year-old male presented with a 30-year-history of a pigmented plaque with cutaneous horns on the right lower trunk. The patient was unsuccessfully treated with various topical and oral medication until he was referred to a tertiary hospital. A biopsy was taken and the cutaneous horns, together with the underlying epithelium, were shaved. The histopathology confirmed PBD and invasive cancer was excluded. He was referred to the plastic surgeons for excision. Case II An 88-year-old male presented with a 30-year history of an asymptomatic pigmented 6cm x 10cm plaque on the left upper trunk, which was unresponsive to topical treatment from different healthcare facilities. The plaque was notched in one area, where there was associated hyperpigmentation. Histopathology of lesional skin confirmed PBD. Conclusion Rare in Africans though it is, skin cancer should always be suspected in a long-standing lesion that does not respond to any treatment. It is essential to biopsy such lesions for histopathological evaluation.