Written by: Deen Kurrimbux

An early form of easily treatable skin cancer. The abnormal growth takes place on the outer layer of the skin called the squamous cells.

Bowen's Disease

When viewed under a magnifying lens these cells appear hexagonal. Bowen’s disease (BD) spreads along the surface of the skin and can bear similar albeit superficial resemblance to eczema or psoriasis. It is therefore important to get correct diagnosis as if neglected BD may spread into deeper layers of the skin and become more serious.

BD can appear anywhere on the body but is usually limited to the arms, legs and trunk. It is a red and scaly 1-3cm patch. In both sexes the genital area can be affected and in men specifically the penis. This is called Bowenoid papulosis (Bowen’s disease of the penis). Bowenoid papulosis appears as a brown patch around the groin area.

BD has a higher incidence in women than in men but both are likely to be affected in later life. People who have had lots of sun exposure coupled with fair skin are often at greater risk.

Bowen's Disease

The causes of BD is said to be idiopathic which means there is an unknown cause; it is neither genetic nor contagious. However, as outlined above, fair skin, exposure to the sun and radiotherapy will increase risks of developing BD but BD is not limited to those areas exposed.

A number of treatment options are available and the specialist dermatologist will consider several factors including location, size, thickness and number of patches. The dermatologist will also consider how likely the skin will fully heal afterwards. Cryotherapy is liquid nitrogen sprayed onto the affected area directly. This effectively kills the cells by a process known as necrosis. The affected area may remain uncomfortable at first and form a blister or scab which will fall off after a few days or weeks. Another form of treatment is chemotherapy cream imiquimod which is, again, applied over the affected area. Surgery may be considered only if the area is relatively small and only few or just one.

After treatment, follow-up appointments are advised to see whether any more treatments are required. If the area starts to bleed or becomes inflamed see the specialist immediately.

BD develops slowly over months or years, the treatments listed above and many more are very effective at curing BD. If left untreated or unmonitored it can develop into a squamous cell carcinoma in 3-5% of people with BD.

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