a 54 year - old - man , presented with multiple , small , well- defined , gray - brown , papules and small papillomatous patches located on his penis , which had appeared over the last year ( figure 1 ) .
genital warts , lichen planus , a verrucous nevus and bp were suspected among our clinical diagnosis .
the dermoscopy revealed a pigmented papillomatous surface , brown - gray dots arranged in a linear distribution at the periphery of the lesion , and widespread dotted vessels ( figures 2 and 3 ) .
a biopsy was done , and the histology showed mild hyperkeratosis , irregular acanthosis , dyskeratosis , cytological atypia and mitosis ( figures 4 and 5 ) , consistent with the diagnosis of bp . a 31-year - old male patient with no relevant medical history presented with gray - brown asymptomatic small papules on his penis that had appeared a few months before ( figure 6 ) .
the dermoscopy revealed multiple areas with grey - brown dots aligned in a linear fashion and a keratotic surface .
a 54 year - old - man , presented with multiple , small , well- defined , gray - brown , papules and small papillomatous patches located on his penis , which had appeared over the last year ( figure 1 ) .
genital warts , lichen planus , a verrucous nevus and bp were suspected among our clinical diagnosis .
the dermoscopy revealed a pigmented papillomatous surface , brown - gray dots arranged in a linear distribution at the periphery of the lesion , and widespread dotted vessels ( figures 2 and 3 ) .
a biopsy was done , and the histology showed mild hyperkeratosis , irregular acanthosis , dyskeratosis , cytological atypia and mitosis ( figures 4 and 5 ) , consistent with the diagnosis of bp .
a 31-year - old male patient with no relevant medical history presented with gray - brown asymptomatic small papules on his penis that had appeared a few months before ( figure 6 ) .
the dermoscopy revealed multiple areas with grey - brown dots aligned in a linear fashion and a keratotic surface .
the natural course of this disease is unpredictable : the lesions may increase , decrease , and even disappear spontaneously .
although progression to an invasive scc is uncommon , it has been estimated in 2.6% of cases .
the most important differential diagnoses are genital warts , both clinically and dermoscopically . to date and to our knowledge , no reports that specifically describe the dermoscopic findings of bp are available , and a few reports of dermoscopic examinations of this dermatosis have been published in the literature .
dong et al .   reported two cases of bp showing an unspecific pattern , and one of the lesions also showed dotted vessels and a keratotic surface as in our first case . in a study describing pigmented lesions of the vulva , ferrari et al .  
also presented 2 cases of bp : one lesion revealed brown to gray structureless areas and glomerular vessels in a clustered and linear arrangement ; the other lacked pigmentation and revealed multiple whitish - red exophytic papillary structures with central glomerular and hairpin vessels .
the features of the two cases we presented were similar : brown - gray dots with a linear arrangement , located at the periphery of the lesion .
these features remind us of pigmented bowen s disease , an in situ variant of cutaneous squamous cell carcinoma , which needs to be differentiated from bp at histopathological level .
although more studies are needed to confirm these findings as criteria for bp , we think that in the presence of linear arrangement of brown - gray dots in a genital lesion , we should rule out bp among other diagnosis .
 bowenoid papulosis ( bp ) corresponds to an in situ squamous cell carcinoma ( scc ) located in the anogenital region . 
 it is related to hpv , and presents with gray - brown elevated papules or plaques . 
 a biopsy is needed to confirm the diagnosis ; however , dermoscopy may be useful to differentiate this disease from other conditions , such as genital warts , seborrheic keratosis and lichen planus . in this paper 
 we describe the dermoscopic findings in two patients with this disease . 
Case report
Case 1
Case 2
Discussion