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Bowenoid Papulosis – Pictures, Treatment, Symptoms, Causes

What is Bowenoid Papulosis?

Bowenoid papulosis is a skin condition that is characterized by papules that appear on male genitalia. Well, that was the original belief of bowenoid papulosis. Nowadays, it is known to occur on the genitalia of both male and females individuals who are sexually active and do not use protective measures. These papules are believed to be benign and harmless, but there is a small chance that the lesions will develop into a malignant skin condition.


This condition is spread virally; it can be transmitted sexually or contracted from sharing undergarments; the causative agent is the human papilloma virus (HPV); the family of HPV is well known for its persistence and its recurrence. Although the lesions are at first asymptomatic, they can be painful, itchy, or inflamed. The condition does not favor any race.

As a piece of advice, a condom or any barrier method should be used to stop the spread of the condition. And furthermore, it is advised to not borrow undergarments or let others borrow your undergarments, for one may not know if a person may be an innocent victim of the disease.

bowenoid papulosis image

Bowenoid Populosis on male genitalia

Sign and Symptoms of Bowenoid Papulosis

Lesions primarily appear on the genital area of a patient (male and female) who has bowenoid papulosis. The appearance of the lesions is similar to genital warts, probably due to the same causative agent. The papules can be small and brown or red in colour, and flat or elevated, They appear on the shaft of the penis in male patients and on the labial folds in female patients. They can also appear on the area around the anus. The condition can start like normal, harmless lesions due to the absence of pain, but the lesions, after some time, can become painful, itchy, and inflamed.

Bowenoid Populosis Pictures

Bowenoid papulosis on perianal area

Bowenoid papulosis on perianal area

Bowenoid papulosis on penile area

Bowenoid papulosis on penile area

Causes and Risk Factors of Bowenoid Papulosis

The causative agent of bowenoid papulosis is HPV, which is the same causative agent of genital warts. It is also categorized as a sexually transmitted disease (STD) because it can be acquired through sexual contact. There are some cases when it can be passed down from mother-to-child during birth, so even in the early life of a child, it can be present, and the symptoms can be felt by the child.

The risk factors can vary; the condition can affect even a baby if the mother is affected as well. Sexually active teenagers and young adults are also predisposed to the condition especially if they do not practice safe sex with multiple partners.

Diagnosis of Bowenoid Papulosis

Like any other skin conditions, the method to diagnose the condition is to perform a skin biopsy. This is a definitive approach to determine the composition and nature of the lesion and to differentiate bowenoid papulosis from other similar skin conditions that are caused by HPV such as genital herpes or genital warts.

A skin biopsy can also be curative since  the treatment of  bowenoid papulosis involves the destruction of the lesions which should be made with sanitary precautions to prevent the spread of the disease.

Treatment of Bowenoid Papulosis

Treatment is mostly superficial. A simple, clean and sanitized destruction of the lesions will do the job, but then again, I will emphasize the use of sanitary precautions to avoid re-infection and the spread of the infection. Retinoids can also help heal the lesions as these chemicals have been proven to be effective against abnormal skin conditions.

There can be a surgical intervention for bowenoid papulosis. But even though we can perform surgery to treat the condition, it is not a practical choice because bowenoid papulosis and other HPV-induced skin conditions are well-known for their high recurrence. There are other methods  to try, but then again, HPV is a persistent virus which can recur any time after those treatment methods. The best thing to do is to stick with a treatment modality that is affordable and inexpensive.

Prognosis of Bowenoid Papulosis

According to the most recent studies, the prognosis varies from person to person. Studies have shown that younger patients who have bowenoid papulosis can have a self-limiting condition which may only last for months; however, in patients who are older, it can last for years. And in cases of patients who are immunocompromised (people with a low immune system), they tend to experience a longer period of the condition which may be impossible to be resolved.

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