Patients often present with an asymptomatic, slowly enlarging, erythematous, scaly patch or plaque. It may occur anywhere on the mucocutaneous surface. A delay in diagnosis often is encountered because the lesion is asymptomatic, early skin changes may be subtle and overlap clinical features seen in many benign conditions. Lesions may appear on sun-exposed or covered skin. The head and neck are the most commonly affected anatomic locations, followed by the limbs.
Lesions vary in size from a few millimeters to several centimeters in diameter.
A sharply demarcated, irregular border usually is present. Lesions are erythematous, scaly patches or plaques that may become hyperkeratotic, crusted, fissured, or ulcerated. Rarely, the lesions are pigmented. Bowen disease also may occur on mucous membranes. When it arises on the glans penis, it is referred to as erythroplasia of Queyrat.