Table 2.

Histopathological variants of Bowen’s disease

Histopathological variant	Diagnostic histopathological clues
Acantholytic	Intraepidermal bulla/cleft in suprabasal location
	Acantholytic anaplastic keratinocytes within bulla
Atrophic BD	Thinning of epidermis
	Full thickness atypia and disorganization
Clear cell BD	Clear cell changes exceed 80% of total tumor population
	Represents outer root sheath differentiation
	Express CK 13, CK 15, CK 16
Epidermolytic	Incidental findings of epidermolytic hyperkeratosis
Irregular BD	Highly pleomorphic
	Absence of either hyperkeratosis or parakeratosis
	Irregular acanthosis
	Extensive chronic inflammation in dermis
Orthokeratotic	Predominant orthokeratosis
	Paucity of parakeratosis
	Preservation of granular layer
Psoriasiform	Parakeratosis
	Regular, marked acanthosis with thickening of rete ridges
Pigmented	Melanin pigments in cytoplasm of atypical keratinocytes
	Increased melanin in melanophages of dermis
Papillomated BD	Exophytic/endophytic growth pattern
	Prominent koilocytosis
Pagetoid BD	Nests of cells with pale cytoplasm
	Intervening thin strands of relatively normal keratinocytes
	May spare the basal layer
	Express cytokeratin 7
Verrucous-	Marked hyperkeratosis and church-spire papillomatosis
Hyperkeratotic
	Intervening pit-like invaginations