Case Number : Case 2689 - 27 October 2020 Posted By: Uma Sundram

A hyperplastic keratosis showing Bowenoid dysplasia with prominent dyskeratosis, acantholysis and a lichenoid reaction.  Early invasion cannot be excluded on this specimen.

?DOIN

Lichen planus turning to Dysplasia

Many years ago I would have called this “lichenoid dysplasia”...

Hello everyone, very difficult case, I'm looking forward to know the final diagnosis and what could teach us @Uma Sundram about this entity.

Actinic keratosis with incidental acantholytic dyskeratosis.

Apologies for the delay in response. Seems to be a habit these days! Sorry, guys. Am chalking it up to Covid 19! Anyway, a difficult case. We did end up saying, we favored reactive but it's a partial biopsy. If clinical concern persists, to re biopsy after treatment. Interesting that most people here thought it was dysplastic. I like sharing these ambiguous cases with you, to see what other people would do.

Agree looks dysplastic. I'd do Ki67, p16, p53.