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What is Bowenoid Papulosis?

By T. K. Marks
Updated Mar 03, 2024
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Bowenoid papulosis is a cutaneous condition wherein pigmented verrucous papules develop on the genitals. These pimple-like skin lesions are typically caused by less than a handful of especially dangerous strains of human papillomavirus (HPV), the virus responsible for genital warts, and can afflict both men and women. This condition is considered precancerous. In a small percentage of cases, the lesions associated with Bowenoid papulosis can can turn cancerous if not monitored.

Frequently, Bowenoid papulosis is mistaken for genital warts. The small red-brown or violet lesions that characterize both conditions are virtually identical to the naked eye. They also both afflict similar parts of the genitals, including the penis, vulvas, labia and anus. A healthcare professional can differentiate between the two, however, by examining a biopsy of the suspicious skin lesion under a microscope. Under high magnification, Bowenoid papulosis will display signs of early squamous cell carcinoma transformations.

Bowenoid papulosis is most closely associated with HPV 16 and a few other potentially cancerous HPV strains. Sexually active people are at greater risk for this condition because of its association with HPV, a sexually transmitted infection. Much like genital warts, Bowenoid lesions are spread through direct contact with infected skin, which means that condom use can lessen the risk of contracting the condition from an infected sexual partner. Also because of its association with HPV, women whose partners suffer from Bowenoid papulosis are at greater risk for cervical cancer. This is because HPV 16 and the few other HPV strains linked with Bowenoid papulosis are also associated with cervical cancer.

There has been no cure found for the condition, but a flare-up usually will disappear within several months. If the patient is pregnant when the condition appears, it will disappear shortly after delivery in most cases. The lesions very rarely become malignant despite being considered precancerous. A small risk does exist, so afflicted skin should be reexamined after three to six months.

In persistent but still benign cases, the lesions can be treated via removal or destruction in the same fashion as genital warts. This is considered the most effective course of treatment by many people in the medical community. There are a number of procedures available to remove the lesions, ranging from surgery to the topical application of certain kinds of acid or liquid nitrogen. The treating healthcare professional will want to continue to monitor the condition after treatment to ensure that it is completely resolved.

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Discussion Comments

By anon342523 — On Jul 22, 2013

Sounds like genital warts in the infancy stage. I'm an MD and I've seen this. Get a new doctor immediately.

By anon268996 — On May 16, 2012

I am 25 years old and sexually active. I have two small freckle like spots on my penis shaft about a half inch apart. Both appeared about two months ago and have stayed the same.

They are light to dark brown and not raised at all. The skin shows no change in texture. Is it possible that these are only freckles or should I be worried about BP. As far as I know freckles are very uncommon on the penis. I showed them to a dermatologist and he said they looked like freckles, but that he could try to freeze them of if I wanted. I chose not to do this because I want to see if they develop into anything that can be diagnosed.

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