Bowen's disease

Bowen's disease
Bowen's disease as seen on a finger
Classification and external resources
Specialty	oncology, dermatology
ICD-10	D04 (ILDS D04.L10)
ICD-9-CM	230–234
ICD-O	8081/2
DiseasesDB	1569
eMedicine	derm/59
Patient UK	Bowen's disease
MeSH	D001913
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Bowen's disease (BD), also known as squamous cell carcinoma in situ is a neoplastic skin disease. It can be considered as an early stage or intraepidermal form of squamous cell carcinoma. It was named after John T. Bowen. Erythroplasia of Queyrat is a particular type of squamous cell carcinoma in situ which can arise on the glans or prepuce in males and vulva in females, and may be induced by human papilloma virus. It is reported to occur in the corneoscleral limbus.

Bowen's disease typically presents as a gradually enlarging, well-demarcated red colored plaque with an irregular border and surface crusting or scaling. BD may occur at any age in adults, but is rare before the age of 30 years; most patients are aged over 60. Any site may be affected, although involvement of palms or soles is uncommon. BD occurs predominantly in women (70–85% of cases). About 60–85% of patients have lesions on the lower leg, usually in previously or presently sun-exposed areas of skin.

This is a persistent, progressive, unelevated, red, scaly or crusted plaque which is due to an intraepidermal carcinoma and is potentially malignant. The lesions may occur anywhere on the skin surface, including on mucosal surfaces. Freezing, cauterization, or diathermy coagulation is often effective treatment. Pathomorphologic study of tissue sampling revealed: polymorphism of spiny epithelial cells has progressed into atypism; increased mitosis; giant and multinucleate cells; acanthosis; hyperkeratosis and parakeratosis; basal membrane and basal layer are retained.

Causes of BD include solar damage, arsenic, immunosuppression (including AIDS), viral infection (human papillomavirus or HPV), chronic skin injury, and other dermatoses.

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