Giant pigmented Bowen’s disease arising from seborrheic keratosis: Morphology, dermoscopy, and surgical management with split-skin grafting

Bowen’s disease (BD) is an in situ squamous cell carcinoma of the skin. Pigmented Bowen’s disease (pBD) is a rare variant, representing less than 2% of all BD cases. We report a case of Giant pBD arising from seborrheic keratosis in a 65-year-old man. The dermoscopy showed a scaly surface, structureless brown to grey-black areas with dotted vessels, glomerular and reticulate vessels, and a few brown globules. Histopathology was classical with a “windblown appearance”; prominent melanophages were seen in the dermis. Owing to the size and thickness of the plaque, a wide excision with a split-skin graft was done. The graft uptake was good, and the patient was followed up on days 4 and 26 post-surgery. We present our experience with the diagnosis and management of this rare case of giant pBD. To the best of our knowledge, such a case has not been previously reported.