The role of reflectance confocal microscopy in a case of Bowen’s disease difficult to diagnose

Abstract

There have been limited reports describing reflectance confocal microscopy (RCM) features of Bowen's disease (BD). Herein, we describe the RCM features of a pigmented BD with atypical dermoscopic features, mimicking a melanoma. This case highlights the importance of RCM in a challenging BD. Bowen’s disease (BD) is an in situ variant of cutaneous squamous cell carcinoma (SCC). The pigmented variant is an important entity in the clinical differential diagnosis of pigmented melanocytic lesions. In most cases of pigmented BD, it is possible to have an accurate preoperative diagnosis with the typical dermoscopic features. Rarely, there may be challenging cases hard to diagnose even with dermoscopic aid [1-3]. In such lesions, reflectance confocal microscopy (RCM) may play an important role as an additional in vivo diagnostic technique [4]. The RCM features of pigmented BD are scarcely in the literature [4-7]. Herein, we report on a case of pigmented BD with atypical clinical and dermoscopic features that mimics a melanoma and describe its RCM features.

Keywords

• Bowen's Disease
• reflectance confocal microscopy
• melanoma