DERMOSCOPY FOR DIAGNOSIS OF BOWEN'S DISEASE IN HIV POSITIVE PATIENTS

Abstract

Bowen's disease (BD) is a form of intraepidermal squamous carcinoma. It occurs in any part of the skin, however the sun-exposed areas are the most prevalent. It might be associated with immunosuppression. A male patient, 46 years-old, diagnosed with AIDS, 55 CD4 cells/mm3. He has reported onset of injury in abdomen, with evolution of six months. On examination, it was nummular plate, erythematous, scaly, in the right flank. The possible diagnoses were seborrheic keratosis irritation, nummular eczema or amelanotic melanoma. From the dermoscopy, it was observed clusters of glomerular blood vessels and white scales. Thus arose the possibility of Bowen's disease. Histopathology was compatible with BD. Dermatoscopy is a noninvasive technique that allows the visualization of morphological structures not visible to the naked eye. In the BD, it is characterized by the presence of vascular structures (glomerular or dotted vessels) and scales on the surface. In this case, dermoscopy was essential to rethink the initial diagnosis of the lesion. Even in non-pigmented lesions, dermoscopy have shown to be an important weapon in the clinical examination of the patient.