LAUSR

A 15-year-old woman presented with a 4-year history of enlarging, tender, verrucous plaque involving the nailfolds of the thumbs (a). Histopathological examination revealed moderate dysplasia of the squamous epithelium with perinuclear haloes, suggesting Bowen disease related to viral infection (c, d). HPV16 positivity appeared in the human papillomavirus (HPV) genotyping polymerase chain reaction test. She was treated with cryosurgery (three freeze–thaw cycles for 30 s, two sessions with a 1-month interval) and HPV vaccine injection (Gardasil ) with no sign of recurrence for 6 months (b). Few cases of HPV-associated Bowen disease of the nail apparatus have been reported. We report a case of HPV16 Bowen disease on the periungual area with favourable outcome following cryosurgery and vaccination.