Cowden's Disease Diagnosed through Mucocutaneous Lesions and Gastrointestinal Polyposis with Recurrent Hematochezia, Unrevealed by Initial Diagnosis

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A 51-year-old man was admitted to our hospital because of hematochezia and painful keratotic plaques involving both hands. He had gastrointestinal polyposis, and a history of liver hemangiomas and thyroid tumor. Numerous papules on the face and papillomatosis on the oral mucosa were present. A diagnosis was made as a typical case of Cowdens disease according to the criteria proposed by Salem and Steck (J Am Acad Dermatol 8: 686, 1983). The patient was not correctly diagnosed initially in spite of typical manifestations of Cowdens disease, mainly due to his concomitant manifestations which occurred chronologically.(Internal Medicine 39: 559-563, 2000)
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