Bowen’s Disease Treatment [Symptoms, Causes & Diagnosis]

Bowen’s disease is a kind of skin cancer that affects the upper layer (epidermis) of your skin. Another name for this disease is squamous cell carcinoma in situ. It usually affects while adults over age 60. Men seem to affect more often than women. It is a very early form of skin cancer that’s easily treatable.

Bowen’s disease was first described in the medical literature by a physician named JT Bowen in 1912. It is generally considered an early, noninvasive form of intraepidermal squamous cell carcinoma. It is sometimes mistaken for other skin conditions such as dermatitis, or psoriasis, fungal infection (tinea) seborrhoeic dermatitis, lichenoid keratosis or porokeratosis. Bowen’s disease treatment are discussed in the main article.

Symptoms

Bowen’s disease causes reddish, sometimes brown, patches on sun-damaged skin, most often on your legs and other parts of the body. You may also see the patches on your head, nape of the neck, palms of your hands, and soles of your feet. Sometimes they develop around genitals.

Most people develop only one patch, but you can have several of them anywhere in your body. They usually don’t cause any discomfort, but they may be:

• Flat
• Larger than a half inch-wide
• Scaly
• Crusty
• Oozing
• Itchy
• Sore

Patches that appear on genital causes problems. In that area, Bowen’s disease may call one of the following.

Bowenoid Papulosis: this affects both men and women causes lesions in the genital area. Bowenoid Papulosis can last from 2 weeks to several years.

Erthroplasia of Queyrat: this affects the tip of a man’s penis. It may cause ulcers as well as discharge of pus, bleeding, itching, or pain when peeing.

Vulvar intraepithelial neoplasia (VIN): In women, it may cause velvety, bright red patches that itch or burn sometimes little pain. The itching can become severe.

Causes

Bowenoid Papulosis is caused by HPV (Human Papillomavirus), which also can cause genital warts and cervical cancer. The virus is the most common sexually active people under the age of 30 are at the highest risk for it because it’s most often passed through skin-to-skin contact.

Scientists a researcher’s aren’t sure exactly what causes the other forms of Bowen’s disease. However, long-term sun exposure and aging may increase your odds of getting may skin cancers, including this one.

Poisoning with arsenic also appear to make you more likely to get an early form of skin cancer.

Histology

In Bowen’s disease, atypical squamous cells proliferate through the whole thickness of the epidermis of the skin. The entire tumor is confined to the epidermis and does not invade into the dermis layer. The cells in Bowen’s disease are often highly atypical under a microscope, and may, in fact, look more unusual than the cells of some invasive squamous cell carcinomas.

Diagnosis

You can’t always tell by looking your skin if you have Bowen’s disease. Many other skin conditions can look the same.

It can be mistaken for the harmless disorder- like rashes or eczema—as well as life-threatening ones, including melanoma. Your doctor usually has to take a sample of your skin for testing (biopsy) to conform it.

Bowen’s Disease Treatment

Bowen’s disease can spread to the deeper layers of your skin. Your doctor (a dermatologist, who specializes in skin care and treatment) probably will recommend a treatment called surgical excision. He’ll gently remove the cancerous area and about a quarter-inch beyond it.

If you have a larger patch, you may need a more detailed procedure for a treatment called Mohs surgery. A thin layer of tissue is removed and looked at under a microscope to study the cancer cell. If cancer cells are seen on the outside edges of the tissue, another thin layer is removed and studied. When no cancer cells are found in the microscope study, the surgery is over.

Besides surgery, other treatment options are:

1. Curettage and electrodesiccation: you’re given a shot of anesthetic to numb the area, and your doctor scrapes off the patches with a special tool. Then He’ll use high-frequency electric current to stop the bleeding. He may repeat the process if there are still cancer cells in deeper tissue.
2. Fluorouracil: It is the medicine for the skin. Fluorouracil keeps abnormal cells from growing and reproducing. It can cause redness, soreness, or peeling after 1 or 2 weeks of applying on the affected area, but this usually goes away within a month or two.
3. Imiquimod: this is also medication you put on your skin. Doctors don’t know exactly how it works against cancer/Bowen’s disease, but when it’s used to treat warts, it helps your immune system fight the virus that causes them.
4. Liquid nitrogen cryosurgery: your doctor sprays liquid nitrogen onto the affected area to freeze it. Afterward, the area will peel, blister, or scab over, depending on the amount used.
5. Laser removal: your doctor will use light energy (photons) to burn off the area.
6. Photodynamics (“light”) therapy: this uses ultraviolet light rays to heal your skin. Sometimes you may put medication on your skin to make the cells more sensitive to the light as the procedure of treatment.
7. Radiation Therapy: one type uses very tiny electrically charged particles (electrons) to target and kill cancer cells. This type of radiation enters only to the upper layers of your skin, so deeper tissues and organs are safe.

If you have Bowen’s disease, you’re at a higher risk for other types of skin cancers, like basal cell carcinoma especially if you have a weak immune system from disease or medical treatments. You should have regular follow-ups and skin, cheeks with your doctor.

More Bowen’s disease treatment options are discussed here- “Cochrane“

Summary

Bowen disease is also known as the clinical term of precancerous skin lesion. It commonly occurs in women and more frequently occurs in the lower limb. in general, people with Bowen’s disease have a magnificent prognosis because the disease is typically slow to develop and respond favorably for the treatment.

There is a various option for Bowen’s disease treatment such as surgical intervention (excision) and Moh’s micrographic surgery. If you are suffering from Bowen’s disease you are the higher risk of suffering other malignancy condition like basal cell carcinoma. so it’s treatment it must. Do visit the surgeon the time.