Bowen's Disease

Definition

Bowen’s disease is a type of slow-growing and scaly skin patch. Someone has says that it is a form of skin cancer. The term "in situ" added on the end tells us that this is a surface form of skin cancer. "Invasive" squamous cell carcinomas are the type that grow inward and may spread. SCC in situ is also known as Bowen's disease after the doctor who first described it almost 100 years ago.

The risk of this happening is hard to asses but studies suggest 3 to 5 out of every hundred of untreated Bowen’s disease will develop into invasive squamous cell cancer. There are many effective treatments to prevent this.

Bowen’s disease is most often seen in people in their 60s and 70s, and is about three times more common in women than men. 

Causes

The exact cause of Bowen's disease is unknown. Like many forms of cancer, long-term sun exposure may be a cause. The cause of Bowen disease classically was prolonged exposure to arsenic. Today, Bowen's disease occurs most often in the sun-exposed areas of the skin in "older" white males

UV radiation (from sunlight or tanning lamps) damages DNA. The radiation actually causes a chemical reaction in the DNA molecule. This damage makes the DNA less able to control how and when cells grow and divide. Usually the body can repair the DNA damage. But if there is too much, in some situations, this results in the start of a cancer.

Symptoms

It is red-brown and scaly or crusted, with little induration, and it frequently resembles a localized thin plaque of psoriasis, dermatitis, or a dermatophyte infection. Bowen's disease usually appears as a red scaly patch often on the legs. There may be more than one patch. The patches grow very slowly and, while they can be a nuisance, they do not cause any serious harm. Occasionally they can develop into a true skin cancer, which will require surgical removal usually, under a local anaesthetic.

Treatment

Treatment of Bowen's Disease generally includes removal of the abnormal skin growth using a freezing method known as cryotherapy or by a procedure known as curettage in which the lesion is simply scraped from the skin in a burning format. Following these procedures, the dermatologist will generally recommend the application of a topical cream to ensure the continual demise of any continuing growth of these skin cancer cells.

Treatment usually involves surgical removal of the lesion. Curettage and cautery methods, which include carbon dioxide lasers, liquid nitrogen, and topical fluorouracil  compose the most efficient treatment for management of small solitary lesions.