Paniel B J, Haddad B, Berville-Lévy S
Service de gynécologie-obstétrique, Centre hospitalier intercommunal de Créteil.
Rev Prat. 1997 Oct 1;47(15):1679-83.
The histological picture of severe stage dysplasia or undifferentiated vulvar intraepithelial neoplasia III is similar in three clinical entities, which should be distinguished because they differ with regard to clinical characteristics, development, prognosis and treatment. They are: 1. Bowen's disease in the menopausal female, which is a precancerous state that in 10 to 30% of cases develops to invasive epidermal cancer. Surgical excision is required. 2. Bowen's papulosis in the young female, known only since the last 2 decades, is the most frequent. It is clinically highly polymorphic. Since it can regress spontaneously and short- and mid-term malignant transformation is rare, conservative treatment should be given. 3. Extensive, patchy Bowen's papulosis in the young female is associated with intraepithelial cervical neoplasia in 85% of cases and with immune deficiency in 30% of cases. Fortunately, it is rare because its risk of malignant transformation is high. Its treatment has not been fully defined but should be as conservative as possible. This clinical distinction is not accepted in the English literature but to us seems of major importance given the need to apply appropriate treatment in each case.
重度发育异常或未分化的外阴上皮内瘤变III级的组织学表现，在三种临床实体中相似，但因其临床特征、发展、预后及治疗存在差异，故应予以区分。它们分别是：1. 绝经后女性的鲍温病，这是一种癌前状态，10%至30%的病例会发展为侵袭性表皮癌，需要手术切除。2. 年轻女性的鲍温样丘疹病，仅在过去20年才为人所知，最为常见，临床症状高度多样，因其可自发消退且短期和中期恶变罕见，故应给予保守治疗。3. 年轻女性广泛、片状的鲍温样丘疹病，85%的病例与宫颈上皮内瘤变相关，30%的病例与免疫缺陷相关，幸运的是，因其恶变风险高，故较为罕见，其治疗方法尚未完全明确，但应尽可能保守。英国文献中未认可这种临床区分，但鉴于每种情况都需要采取适当治疗，我们认为这至关重要。
