Pigmented Bowen's Disease (Squamous Cell Carcinoma in situ): A Mimic of Malignant Melanoma

Background. Darkly pigmented individuals may manifest unusual or uncharacteristic presentations of various skin conditions, including heavy pigmentation of cutaneous tumors. Objective. To increase the awareness of an unusual presentation of Bowen's disease in a darkly pigmented individual. Methods. We report the case of a 52 year old black woman that presented with a lesion clinically consistent with malignant melanoma. However, histopathologic examination revealed pigmented Bowen's disease. Results. A biopsy is almost always indicated to confirm the diagnosis of lesions in darkly pigmented individuals. Conclusion. This case is presented to reinforce the idea that pigmented Bowen's disease should be considered in the differential diagnosis of malignant melanoma.