Dermoscopic findings of genital keratotic lesions: Bowenoid papulosis, seborrheic keratosis, and condyloma acuminatum

Photodiagnosis Photodyn Ther. 2021 Dec:36:102448. doi: 10.1016/j.pdpdt.2021.102448. Epub 2021 Jul 19.

Abstract

Dermatologists often encounter keratotic or warty lesions in the genital area. Establishing a clear diagnosis may seem challenging, particularly when the differential diagnosis includes bowenoid papulosis, seborrheic keratosis, and condyloma acuminatum. This study aimed to compare the dermoscopic features of bowenoid papulosis (BP), seborrheic keratosis, and condyloma acuminatum in the genital area. All lesions histopathologically confirmed underwent clinical assessment and dermoscopic observation. Dermoscopically, glomerular vessels were predominant in bowenoid papulosis, whereas seborrheic keratosis was the least vascular-patterned disease. Most cases of bowenoid papulosis presented mucosal pigmentation and classified as "flat". Seborrheic keratosis had a pigmented, cerebriform appearance. Condyloma acuminatum was characterised by a finger-like appearance, highly vascular-patterned features surrounded by whitish halos. Dermoscopic findings can be useful for differentiating the entity of genital keratotic lesions ahead of an invasive method. When dermoscopic features favor BP, different from genital warts, it should be removed completely but conservatively.

Keywords: Bowenoid papulosis; Condyloma acuminatum; Dermoscopy; Genital seborrheic keratosis.

MeSH terms

  • Condylomata Acuminata* / diagnostic imaging
  • Dermoscopy
  • Diagnosis, Differential
  • Genitalia
  • Humans
  • Keratosis, Seborrheic* / diagnostic imaging
  • Photochemotherapy* / methods
  • Photosensitizing Agents
  • Skin Neoplasms* / diagnostic imaging

Substances

  • Photosensitizing Agents