Bowenoid change in perianal condyloma acuminatum associated with ulcerative colitis.

A 35-year-old male patient with a 20-year history of ulcerative colitis developed an itching perianal condyloma acuminatum with discharge. This was surgically removed after two years. Histology revealed bowenoid change in the condyloma. Six months later a local recurrence was excised. He has now been free of further recurrence for 5 years. Electron microscopy showed moderately differentiated keratinocytes in the areas of bowenoid change. There was no evidence of virus particles in the keratinocytes. A causal relationship has been assumed between the ulcerative colitis, via chronic irritation, and the perianal bowenoid changes regarded as in situ carcinoma. The importance of radical excision of such lesions is emphasized.