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Bowenoid papulosis of vulva

Last edited: 4/10/2026

Overview

Bowenoid papulosis is a benign, multifocal, papular variant of vulvar squamous cell carcinoma in situ 1. It is characterized by the presence of atypical squamous cells confined to the epidermis 1.

Diagnosis

  • Diagnosis is typically made via biopsy of suspicious lesions 1.
  • Histologic examination reveals features of squamous cell carcinoma in situ, including koilocytotic atypia and nuclear pleomorphism, with preservation of epidermal architecture 1.

    • Management

  • Management options include observation, topical therapies (e.g., imiquimod, 5-fluorouracil), and surgical excision 1.
  • The choice of treatment depends on the extent of disease, patient symptoms, and patient preference 1.
  • For extensive or symptomatic disease, surgical excision may be considered 1.
  • Topical imiquimod has shown efficacy in treating Bowenoid papulosis 1.

    • Key Recommendations

  • Diagnosis of vulvar skin disorders, including Bowenoid papulosis, is typically confirmed by biopsy 1. (Evidence: Expert opinion)
  • Management of Bowenoid papulosis can include observation, topical therapies such as imiquimod, or surgical excision 1. (Evidence: Expert opinion)
  • Topical imiquimod is an effective treatment option for Bowenoid papulosis 1. (Evidence: Moderate)

    • References

    1 . Diagnosis and Management of Vulvar Skin Disorders: ACOG Practice Bulletin, Number 224. Obstetrics and gynecology 2020. link

    Original source

    1. [1]
      Diagnosis and Management of Vulvar Skin Disorders: ACOG Practice Bulletin, Number 224. Obstetrics and gynecology (2020)
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