Bowen's disease of the vulva

The lesion is extremely well defined and in this case is a pigmented rather than erythematous plaque. Biopsy showed intraepidermal carcinoma. The whole area was excised and grafted after a temporary defunctioning colostomy. There was a perfect recovery with resumption of satisfactory sexual activity and no recurrence 10 years later, although the patient did develop a vulval wart which was excised. Some believe that the human papilloma virus is implicated in Bowen's disease and especially in its variant Bowenoid papulosis.