Bowenoid papulosis was previously considered a rare form of genital warts but more recently is being considered as an early or transitional form of skin cancer. Bowenoid papulosis is seen in both genders and is transmitted in sexually active people. It has been linked to many forms of human papillomavirus or HPV, most commonly HPV 16. It is important to note that HPV is passed most commonly through direct skin to skin sexual contact. Those at highest risk for developing bowenoid papulosis are sexually active individuals under age 30 years old. Many cases of bowenoid papulosis remain non-cancerous or benign, but progression to cancer has been reported. Bowenoid papulosis often appears as a single papule or raised bump on the genitalia or as multiple papules that often grow together to form a patch. In women the bumps are most commonly found on the labia; in men on the shaft of the penis. The bumps can be flesh colored or dark in color and can sometimes be painful or red.
Diagnosis is based on physical appearance and sometimes also on biopsy, where the cells from the bumps are observed under a microscope. Most cases of bowenoid papules disappear on their own after a few months, if not, they can be treated as genital warts and can be removed. Common treatments for genital warts include topical medications and cryotherapy, which is the use of liquid nitrogen to freeze and kill the wart cells. When removed, the risk for the progression to cancer is low. In women, bowenoid papulosis is associated with abnormal pap or cervical smears and women who are sexually active with a partner with bowenoid papulosis are at a greater risk for cervical cancer. It is important to have any lesion on the genitalia evaluated by a doctor and biopsied to rule out bowenoid papulosis. If you or your partner has been diagnosed with bowenoid papulosis, talk with your doctor or health care provider about the most current treatment options.