Periungual Bowen disease mimicking chronic paronychia and diagnosed by dermoscopy

A 75-year-old woman, with Fitzpatrick skin phototype I/II and a history of nonmelanoma skin cancer presented with a scaly, fissured, erythematous, fairly well demarcated patch involving the periungual skin of the left index finger (Fig 1). The lesion had persisted for >1 year despite the use of antibiotic and corticosteroid ointments. The patient was immunocompetent, an exsmoker, with no reported history of arsenic ingestion, trauma, burns, or ionizing radiation to the site.