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Home :: Skin Disorders

Bowen's Disease - Definition, Causes, Symptoms and Treatment


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Bowen's disease is a skin lesion that affects the topmost layer of the skin. It usually appears as a slow-growing red and scaly patch. Occasionally one can turn into true skin cancer. It is also called squamous cell carcinoma-in-situ. Pre-invasive means that cancer cells tare present. But they are only in the outermost layer of skin, the epidermis. This means that the cancer cells will not spread to the lymph nodes. But it does often spread along the skin surface.  It is thought to develop partly as a result of long-term sun exposure. Bowen's disease is not infectious or due to an allergy. Some researchers believe Bowen's disease is a type of skin cancer, while others consider it to be a pre-cancerous condition. However, the patches do not usually develop into skin cancer. Bowen's disease can occur on any part of the body, however, the lower legs are most commonly affected.

Bowen's disease is easily overlooked because the lesions present no symptoms. It is not unusual for Bowen's disease to be diagnosed during medical investigations for other complaints. Bowen's disease can be confused with such other common skin disorders as psoriasis or types of dermatitis. Exposure to sunlight is a known risk factor, yet the actual cause of Bowen's disease is unknown. Women are more susceptible than men and age seems to be a factor, as most cases occur in people over 40 years. A patch of Bowen's disease can look rather like other skin conditions, such as psoriasis. Several treatments are available for Bowen's disease, such as freezing it, scraping it off the skin, and surgical removal.

Causes of Bowens disease

The exact cause of Bowen's disease is unknown. Long-term exposure to sunlight is a cause of some lesions but in many cases of Bowen's disease there is no obvious cause. It is seen most often on the legs of women. Bowen's disease is not infectious or due to an allergy. The role of heredity is not well understood.

Common causes and risk factors of Bowens disease:

  • Long-term sun exposure.
  • Human papilloma virus infection.
  • Immunosuppression.
  • Chronic skin injury.
  • Dermatoses.

Signs and Symptoms of Bowens disease

Sign and symptoms may include the following :

  • Slightly raised red patches.
  • The edges of each patch are irregular but distinct from the surrounding skin.
  • Itching.
  • The patch or patches grow very slowly.
  • In some cases, the affected skin may become soreand bleed.

Treatment for Bowens disease

Several treatments are available for Bowen's disease, such as freezing it, scraping it off the skin (curettage), and surgical removal. In some cases a cream known as 5-fluorouracil may be used. X-ray or grenz ray radiation can be given to poor surgical candidates or patients with multiple sites. This is very expensive and requires multiple visits to the hospital. very promising new treatment is Aldara cream. This may have a better cure rate, but is still undergoing studies.

Treatment may include:

  • Freezing can be done in stages for large areas of Bowen's disease.
  • In some cases a cream known as efudix cream may be used.  
  • Photodynamic therapy is available in some clinics now: radiotherapy is being used less often.  
  • Wear a wide brimmed hat and protective sunglasses.