Bowenoid in situ carcinoma (multicentric squamous cell carcinoma in situ, Bowen disease) is characterized by heavily scaled, crusted, and pigmented papules and plaques with some erosion (FIGURE 6).29 Lesions can present in any location but mostly appear on the face, shoulders, and limbs.30 They are multicentric and discrete, and the affected area may or may not be exposed to the sun.