Refractory Vulvar Bowen’s Disease: A Case Report and Literature Review

Vulvar Bowen’s disease, a rare form of vulvar intraepithelial neoplasia (VIN III), represents a precancerous lesion mostly linked to high-risk human papillomavirus (HPV) infection. Diagnosis is often delayed due to non-specific clinical presentation mimicking benign dermatoses. We report the case of a 63-year-old woman with a chronic pruritic vulvar lesion initially treated unsuccessfully with topical corticosteroids. Biopsy confirmed HPV-associated Bowen-type VIN III. Topical treatment with 5-fluorouracil was ineffective, and complete surgical excision with clear margins was performed. This case highlights the importance of early histological diagnosis and tailored management to prevent progression to invasive carcinoma.