Isolated extragenital HPV-thirties-group-positive bowenoid papulosis in an AIDS patient

The term 'bowenoid papulosis' (BP) was introduced in 1978 to describe multiple verrucous papules on the genitalia with a histological resemblance to Bowen's disease and a clinical resemblance to condylomata. ' BP is primarily a disease of sexually active young people, with a mean age of onset of about 30 years.' Multiple 2-10 mm red-brown or violaceous papules, some with a verrucous surface, may coalesce into plaques. The clinical spectrum includes lichenoid papules, erythematous macules and 'leukoplakia-Iike' lesions.^ •* BP occurs most frequently on the genitalia, perianal skin or crural regions, and there is a slight female predilection.^"* There are rare reports of extragenital BP with concomitant genital involvement. Histologically, BP exhibits many features of Bowen's disease: crowded, pleomorphic 'windblown' keratinocyte nuclei with occasional mitotic figures, and cytological atypia, which is usually less pronounced than in Bowen's disease.' '* Viral features are characteristically absent on routine haematoxylin and eosin-stained sections, although BP is caused by a human papillomavirus. In essence, cutaneous and genital BP are HPV-induced mild, moderate, or severe degrees of intraepithelial dysplasia. We describe an AIDS patient with isolated extragenital bowenoid papulosis. In situ hybridization studies revealed an unusual HPV subtype.