We report a case of perianal Bowen's disease in a 61-year-old woman with a complete response to 5% topical imiquimod. She presented with a brownish plaque in the perianal area. A biopsied specimen showed epidermal hyperkeratosis, acanthosis, proliferation of atypical keratinocytes, abnormal mitosis and multinucleated cells, which led to the diagnosis of Bowen's disease. The lesion completely disappeared after application of 5% topical imiquimod three times a week for 8 weeks. No relapse was observed either clinically or histologically three months after the treatment.
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