What are key histological features of Bowen's disease?

Bowen's disease is characterized histologically by significant alterations in the structure of the epidermis. The loss of nuclear polarity and stratification is a key feature that indicates a disturbance in the normal organization of epithelial cells. In this condition, keratinocytes demonstrate atypical nuclear features, including irregular shapes and sizes, and their arrangement becomes disorganized.

This abnormality is reflective of dysplastic changes associated with pre-malignant lesions, which can progress to squamous cell carcinoma if left untreated. The presence of these features marks the transition from normal skin to the dysplastic state seen in Bowen's disease.

Other features, while they may be present in related conditions, do not specifically define Bowen's disease histologically. Prominent intercellular bridges are typically associated with more differentiated squamous cell lesions rather than the disorganized growth found in Bowen's disease. Invasive growth patterns would suggest a malignancy beyond the pre-malignant state of Bowen's disease, and a low mitotic index does not align with the high level of atypical mitotic activity observed in these dysplastic keratinocytes.