Bowen’s disease is a skin condition often questioned for its connection to cancer. It appears as a persistent, reddish, scaly patch, making understanding its nature important for management.
What is Bowen’s Disease
Bowen’s disease is an early form of skin cancer, appearing as a slow-growing, red, scaly patch. This patch has clear, defined edges and may be flat or slightly raised, sometimes appearing crusty or itchy. It can occur anywhere but is frequently found on sun-exposed areas like the lower legs, head, and neck.
Its appearance can be mistaken for eczema, psoriasis, or fungal infections. It typically affects individuals in their 60s and 70s, with long-term sun exposure as a primary risk factor. Other factors include a weakened immune system, previous radiotherapy, or human papillomavirus (HPV) infection.
Is Bowen’s Disease Cancer
Yes, Bowen’s disease is an early form of squamous cell carcinoma (SCC) in situ. This means abnormal cells are confined to the outermost skin layer (epidermis) and have not invaded deeper layers or spread. Because cells are localized, it’s often described as “pre-invasive.” If untreated, there is a 3% to 10% chance it could progress to invasive SCC. However, due to its non-invasive nature at this stage, Bowen’s disease is highly treatable.
Diagnosis, Treatment, and Prognosis
Diagnosing Bowen’s disease begins with a healthcare provider examining the suspicious patch. As its appearance can mimic other conditions, a definitive diagnosis requires a skin biopsy. A small sample of affected skin is removed under local anesthetic and examined under a microscope.
Several effective treatment options are available, chosen based on factors like lesion size, location, and patient health. Common treatments include:
Cryotherapy, which uses liquid nitrogen to freeze and destroy abnormal cells.
Topical chemotherapy creams, such as 5-fluorouracil (5-FU) or imiquimod, applied directly to the affected area to eliminate cancerous cells.
Curettage and cautery, where affected skin is scraped away and sealed with heat or electricity.
Surgical excision, which involves cutting out the abnormal skin under local anesthetic.
Photodynamic therapy (PDT), using a light-sensitive cream activated by a specialized light source to destroy cells.
The prognosis for Bowen’s disease is generally good with treatment, boasting high cure rates and a low risk of progression. Regular follow-up appointments and diligent sun protection are recommended to monitor for recurrence or new lesions.