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Bowen disease

Bowen’s disease is a form of skin cancer affecting the upper layer of skin (epidermis); it is considered a squamous cell carcinoma in situ. Most of these lesions are due to chronic ultraviolet radiation, typically from the sun. It most commonly affects the head, neck, trunk, arms or lower legs. If left untreated, Bowen’s disease can progress into invasive skin cancer referred to as squamous cell cancer (SCC).

Bowen’s disease most commonly presents as a slow growing, persistent red scaly patch on areas of skin chronically exposed to the sun. There are often no symptoms and hence there is often delay in seeking treatment. It can be mistaken for eczema, psoriasis, fungal infection (tinea), and a few other skin conditions. The diagnosis is made clinically by a physician and sometimes confirmed by a biopsy.

Along with ultraviolet radiation, other potential causes of Bowen’s disease include:

  • Immunosuppression (e.g. kidney/liver/heart transplant patients)
  • Arsenic exposure (rare now)
  • Human papilloma virus infection (HPV)
  • Ionizing radiation
  • Rare genetic disorders

There are a variety of treatment options depending on the size and location of the lesion, the age and health of the patient, cosmetic concerns, previous treatments tried, and cost & availability of treatment. Treatment options include:

  • Liquid nitrogen cryotherapy
  • Surgical excision
  • Curettage & electrocautery
  • Photodynamic therapy
  • Radiotherapy
  • Topical chemotherapy: 5-fluorouracil (Efudex), Imiquimod (Aldara, Zyclara), & Ingenol mebutate (Picato)

A small percentage of cases will recur after treatment and so ongoing surveillance is advised, as well as continued sun protection and avoidance measures.

Here is a selection of media & scientific articles with our renowned dermatologists Dr. Benjamin Barankin and Dr. Anatoli Freiman as they pertain to Bowen’s disease. Toronto Dermatology Centre is proud to be among the largest & most comprehensive treatment centres for skin cancer in Canada as well as amongst the most widely published in the scientific literature on skin cancer in Canada.

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