Two Asymptomatic Lesions: Neighbors, But Are They Related?

January 2, 2003

Satellite lesions are usually associated with Candidainfections but not with Bowen disease.

In one of Dr David Kaplan's "Dermclinic" cases (CONSULTANT, June 2002, page 840), I noticed a red lesion on the patient's back below a crusty patch that was identified as Bowen disease (Figure). Is this a satellite lesion? -MD Satellite lesions are usually associated with Candida infections but not with Bowen disease. Multiple lesions are sometimes seen in Bowen disease, but the lesions would appear similar. This lesion is a cherry angioma that happens to be in the same vicinity as the Bowen disease but is unrelated. Bowen disease lesions are usually quite friable, while cherry angiomas are not. If the upper lesion had demonstrated scaling (which is typical of Candida infections) rather than the crusting seen here, a potassium hydroxide examination could help establish the diagnosis.

-David L. Kaplan, MD
  Clinical Assistant Professor of Dermatology
  University of Missouri Kansas City School of Medicine
  University of Kansas School of Medicine
  Kansas City, Kan

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