What is Bowenoid papulomatosis?

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Last updated: February 11, 2025View editorial policy

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From the Guidelines

Bowenoid papulomatosis is a premalignant clinical entity, a form of penile intraepithelial neoplasia (PIN), characterized by raised papules on the penile shaft skin, often associated with HPV infection.

Key Characteristics

  • Typically occurs in young, sexually active men 1
  • Most common on the glans, over the shaft, prepuce, and groin, and can also be seen around the anus 1
  • Histologically indistinguishable from Bowen’s disease and erythroplasia of Queyrat, but has a lower risk of developing into squamous cell carcinoma (SCC) 1

Risk Factors

  • Lack of circumcision 1
  • HPV infection 1
  • Genital lichen sclerosus 1

Diagnosis and Treatment

  • Early biopsy is essential to establish the diagnosis 1
  • Treatment can be difficult, especially in cases with urethral involvement 1
  • Circumcision is an important component of management in most cases of PIN 1

From the Research

Definition and Characteristics

  • Bowenoid papulosis (BP) is characterized clinically by its benign-looking appearance and histologically by the features of high-grade squamous intraepithelial lesions (SILs) 2
  • It is a condition with specific features that distinguish it clinically and histologically from carcinoma in situ and condylomata acuminata 3
  • BP is manifested by clinically benign-appearing papules of the anogenital region, which histologically shows the changes of squamous cell carcinoma in situ 4

Etiology and Association

  • A strong association between BP and high-risk types of human papillomavirus (HPV), especially HPV 16, has been reported 2, 5
  • The condition is related to HPV and presents with gray-brown elevated papules or plaques 6
  • Some evidence suggests a viral origin on the basis of infection with high-risk oncogenic genotypes of human papilloma viruses (HPV 16/18 and others) and an association with cervical carcinoma 5

Diagnosis and Treatment

  • A biopsy is needed to confirm the diagnosis of BP 6
  • Dermoscopy may be useful to differentiate this disease from other conditions, such as genital warts, seborrheic keratosis, and lichen planus 6
  • Imiquimod cream (Aldara) has been used as a safe, efficacious, and practical patient-applied therapeutic option for the treatment of BP 5
  • Conservative therapy is suggested for BP, and most lesions undergo resolution by local treatments or even spontaneously 2, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Bowenoid papulosis showing polyclonal nature.

Diagnostic molecular pathology : the American journal of surgical pathology, part B, 1998

Research

[Imiquimod: a new treatment possibility in bowenoid papulosis?].

Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 2001

Research

Dermoscopic findings in bowenoid papulosis: report of two cases.

Dermatology practical & conceptual, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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