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In Bowen’s disease, the skin cancer is located only in the epidermis, the uppermost layer of the skin. Rarely, the skin cancer can invade into the dermis and then it is called an invasive squamous cell carcinoma. Only invasive squamous cell carcinoma can metastasise to other parts of the body and become a life-threatening skin cancer.
Bowen’s disease can occur on any part of the body, although the lower legs are most commonly affected. It is easily mistaken for , another skin complaint characterised by red scaly patches.
Fair skin and exposure to sunlight are the main risk factors for Bowen’s disease
Women are more susceptible than men and most cases occur in people over 40 years.
The condition isn’t contagious and treatment is usually successful
The signs of Bowen’s disease include:
- Flat scaly
- slightly raised patches appear
- persist for months to years
A single patch or a number of patches may be present. The edges of each patch are irregular, but distinct from the surrounding skin.
Each patch grows very slowly
Bowen’s is asymptomatic (has no symptoms) and therefore is easily overlooked. Bowen’s can affect any part of the body, but commonly occurs on the lower leg.
Only rarely are the patches sore or irritated
However, if left untreated, the affected cells may migrate deeper into the skin layers.
If a patch of Bowen’s disease becomes raised, tender or is bleeding, then it will need immediate medical attention. The cause of Bowen’s disease is often unknown, but known risk factors include: – the condition is more common in women.
Elderly women are particularly prone
– Bowen’s disease is more common in sunny countries. Bowen’s is most common on parts of the body exposed to direct sunlight. – people who are exposed to arsenic are at increased risk. – this is required by organ transplant recipients to prevent organ rejection.
– infections with certain subtypes of the human papilloma virus (wart virus) can predispose to Bowen’s disease. This is especially relevant for genital Bowen’s disease. Bowen’s disease produces persistent red scaly patches on the skin that are not sore or itchy.
Bowen’s disease is easily overlooked. It is not unusual for Bowen’s disease to be diagnosed during a routine skin examination. Diagnosis methods include:
- biopsy of the lesion
- including laboratory examination of the tissue sample
Treatment options include:
- the base of the wound is treated with cauterisation
- where the skin is lightly burnt with an electric current
It has a success rate of around 90 per cent when performed by dermatologists. – a special type of light is used to destroy the lesion. Success rates are in the order of 60-80 per cent with a specialist.
– these are applied to the lesion to kill its cells. They include 5-fluorouracil cream and Imiquimod cream. Success rates are similar to PDT. – the lesion is cut out and the wound is sutured closed. This treatment has a near 100 per cent success rate, but will leave a surgical scar.
– is rarely used now. About bowen’s disease Bowen’s disease is an early form of skin cancer that appears as a persistent, slow-growing, red and scaly skin psoriasis Signs of Bowen’s disease Bowen’s disease may become invasive In most cases, Bowen’s disease remains confined to the upper layer of the skin (epidermis) Risk factors for Bowen’s disease Gender Age Sun exposure Arsenic Systemic immunosuppression Viral infection Diagnosis of Bowen’s disease physical examination medical history Treatment for Bowen’s disease Cryosurgery Curettage Photodynamic therapy (PDT) Topical creams Surgery Radiation therapy Where to get help Your GP (doctor) Dermatologist.
Key Points
- Bowen’s disease can occur on any part of the body, although the lower legs are most commonly affected
- Fair skin and exposure to sunlight are the main risk factors for Bowen’s disease
- condition isn’t contagious and treatment is usually successful
- Bowen’s is asymptomatic (has no symptoms) and therefore is easily overlooked
- Bowen’s can affect any part of the body, but commonly occurs on the lower leg