Pigmented lesion on neck.

A 57 year-old-woman consulted for a pigmented lesion on her neck.

Dermoscopy revealed:

• no melanocytic structures
• a structureless pattern
• irregular blue gray dots/globules 

Pathology was in favor of a Bowen's disease.

Dots in lines...

A 75-year-old man consulted for a pigmented lesion on his right ear. This lesion was located on helix.

Dermoscopy revealed a light brown structureless area with some brown dots arranged in lines in the periphery.

Focal arrangement of brown dots in lines (red arrows) is clearly seen on the dermoscopic picture above.

A biopsy was performed and revealed a Bowen's disease.

This arrangement of brown dots in lines has been recently reported in the Journal of American Academy of Dermatology * by H. Kittler and al. It is typical of pigmented Bowen's disease.

*A Cameron, C. Rosendahl, P. Tschandl, E. Riedl, H. Kittler. Dermatoscopy of pigmented Bowen's disease. J Am Acad Dermatol 2010; 62: 597-604.

Glomerular vessels

A 65-year-old woman consulted for this red lesion on her right leg for 8 months. (clinical picture above)

Fig 1: polarized-light contact dermoscopy with a slight pressure
of the dermoscope.

Dermoscopy with a polarized-light contact dermoscope revealed an unspecific pattern and typical glomerular vessels in a symmetric distribution, in favor of a Bowen disease.

Fig 2: polarized-light contact dermoscopy with
a heavier pressure of the dermoscope which emptied
the blood vessels.

Polarized-light dermoscopy offers a better visualization than contact-light dermoscopy for blood vessels whatever the type of vessels, at the condition not to heavily press on the lesion.

Glomerular vessels are the specific local criteria for diagnosing Bowen disease.

Other non specific criteria for Bowen disease are:

• unspecific global pattern
• scales *
  
• ulceration*
  

* not present in our case

Glomerular vessels

Glomerular vessels are typically found in Bowen disease.

In this case, glomerular vessels were the main clue for the diagnosis of Bowen disease for this 72-year-old woman who presented a reddish and well circumscrined plaque on her right forearm.


Other cases: 1 2 3

Glomerular vessels

A 72-year-old woman consulted for this pink lesion on her right leg.
Dermoscopy revealed spared glomerular vessels in favor of a Bowen disease.

Bowen's disease

A 84-year-old woman presented a keratotic erythematous lesion of her right leg.



Dermoscopy revealed scales many glomerular vessels in favor of a Bowen's disease.
See the glomerular vessels. The pressure of the dermoscope has to be slight not to empty the vessels. Polarized dermoscopy is more performing than contact immersion dermoscopy to see accurately vessels.

Bowen's disease

A 75-year-old woman consulted for an enlarging red tumor of her right ankle.

Dermoscopy (x20) revealed numerous glomerular vessels in favor of a Bowen's disease.

A biopsy was performed and pathology confirmed the diagnosis.