Bowen’s Disease

What is Bowen’s Disease?

Intraepidermal squamous cell carcinoma or Bowen’s disease is named after the American dermatologist John. T. Bowen. Bowen’s disease is a skin disease that marks the early onset of skin cancer. The main symptom of Bowen’s disease is a red, scaly patch.The disease affects the squamous cells in the outermost skin layer. It starts as a slow growing small patch on sun-exposed area like hands, neck, face, etc. The formation of a boil or bump on the affected area indicates formation of aggressive squamous cell cancer. If left untreated, it can spread further, affecting a larger area. The patch grows at a very slow rate and may bleed at times. It may be mistaken with a ringworm or psoriasis disease. Patches in this disease can be a few millimeters in diameter, but can grow to centimeters.

Symptoms

The first symptom of Bowen’s disease is a red looking patch with an uneven boundary. The patch may appear on an area of the skin, especially the sun exposed area. Few of the other symptoms include:

Ulcer.
Bleeding lump.

Causes

The main causes of this disease include:

Exposure to UV radiations.
Formation of mutant clone gene, p53.
Uncontrolled growth of skin cells.

Risks

The major risk factors of this disease include:

Long-term sun exposure and sun burns.
Previous history of carcinoma.
Skin injury that caused skin damage or scarring.
Skin inflammation like eczema.
Human papillomavirus (HPV) that affects the skin lining and mucosa.

Prevention

In order to prevent the occurrence of this disease, one should take care of the following:

Using a sunscreen which has at least SPF 15.
Staying in the shade as much as possible.
Covering up the skin while exposure to sun.

How is it diagnosed?

The disease can be suspected by appearance of patch on the skin. To rule out the occurrence, a small sample of skin for biopsy purpose is taken. The sample is examined closely under the microscope ...

How is it treated?

At Medanta, depending upon the severity and affected area, a dermatologist can recommend any one of the available options for treating Bowen’s disease. The highest recommended treatments are:

Cryotherapy

The affected area is freezed with the help of nitrogen spray. Though the procedure is painful, yet effective as the skin scabs and falls off by itself after a few days.
Chemotherapy

The Imiquimod ointment like 5-fluorouracil is applied onto the affected area for a due course of time. The ointment causes the skin to inflammate and become red. Gradually, the area becomes better with time.
Curettage and cautery

Under the effect of local anesthesia, the affected skin is numbed and scraped or removed. Heat or electricity is used to stop bleeding and left to heal over time. Antibiotics are prescribed to keep away infections.
PDT (Photodynamic Therapy)

With the help of laser, cells of the affected area are burnt or killed. The procedure is completed with the help of a light-sensitive cream. The entire course lasts for about 20-45 minutes, and the number of sittings may vary depending on the requirement.
Surgery

This forms the last option of treatment in any case. It involves removing the affected skin under local anesthesia effect, and then stitching to seal the wound.

When do I contact the doctor?

Persistent appearance of red, scaly patch on the exposed area, which seems to be increasing and no definite cause is known, marks the importance of a doctor’s advice. A dermatologist is the best person to seek guidance from.

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