Verrucous Bowen\\\'s disease: A case report of an unusual variant

Abstract

Squamous cell carcinoma in situ, often known as Bowen's disease, is a type of intraepidermal carcinoma that is most frequently observed in the older population in places that are particularly exposed to the sun. The advancement of this neoplasm to invasive squamous cell carcinoma (SCC) occurs in fewer than five percent of instances, and it is often the case that it is indolent. An erythematous, crusty, and scaly plaque is the typical manifestation of Bowen's disease. However, reports have documented other rare presentations, including pigmented, atrophic, hypertrophic, or verrucous lesions. We present a case of a 72-year-old female patient who, over a period of four years, presented with a progressively increasing tumor on her left buttock. The clinical examination revealed a hyperkeratotic plaque that was well-defined, raised, verrucous, and crusted. The plaque measured 8 x 10 cm. The histopathological examination revealed a diagnosis of Bowen's disease, which was developing into squamous cell carcinoma. The plastic surgeon carried out a wide local excision, followed by full-thickness skin grafting. We hereby are reporting this case for its unusual presentation in a sun-protected area, its rapid progression to squamous cell carcinoma with no evidence of immunosuppression, and how early diagnosis, timely invasion, and treatment play a key role in avoiding metastasis.