Solitary Pigmented Bowen's Disease

Bowen's disease is an intraepidermal carcinoma that occurs most commonly in white men. The average age at diagnosis is 55 years. The lesion is often solitary, and appears grossly as a discrete, red, and slightly scaling plaque, which gradually enlarges in a somewhat irregular pattern. We describe herein a patient who was initially seen with Bowen's disease, in which a lesion, apparently present since early childhood, resembled a malignant melanoma. Report of a Case A 63-year-old white man entered the Veterans Administration screening clinic in Columbus, Ohio, with a long history of emphysema and was subsequently referred to the dermatology clinic for evaluation of a large "mole" on his neck. By history, the lesion had been present in childhood, and the patient's family had called it a birthmark. It had cause the patient no discomfort, but during the year prior to examination he had noted an irregular enlargement. Examination disclosed