Bowen’s Disease

Below you will find more information about Bowen’s Disease from Medigest. If you believe that you are suffering from any of the symptoms of Bowen’s Disease it is important that you obtain an accurate diagnosis from a medical professional to ensure that you obtain the correct medication or treatment for your condition. There are medical conditions that carry similar symptoms associated with Bowen’s Disease and therefore the information provided by Medigest is offered as a guideline only and should never be used in preference to seeking professional medical advice. The information relating to Bowen’s Disease comes from a third party source and Medigest will not be held liable for any inaccuracies relating to the information shown.

Definition

Bowen's disease (BD) is a skin disease induced by sunlight, considered either as an early stage or intraepidermal form of squamous cell carcinoma.

Prevalence

A 1991 study from Minnesota reported the annual average rate of Bowen disease as 14 cases per 100,000 whites. In 1994, a study from Hawaii reported a rate 10 times that, with 142 cases per 100,000 whites.

Symptoms and Signs

Bowen's disease generally presents as a gradually enlarging, well demarcated erythematous plaque with an irregular border and surface crusting or scaling. BD may occur at any age in adults but is rarely found in people below 30 years of age; most patients are aged over 60. Any site may be affected, although palms or soles are rarely involved. BD occurs predominantly in women (70-85% of cases); about three-fourths of patients have lesions on the lower leg (60-85%), usually in previously or presently sun-exposed areas of skin. There may be persistent progressive non-elevated red scaly or crusted plaque which is due to an intradermal carcinoma and is potentially malignant. Atypical squamous (resembling fish scales) cells proliferate through the whole thickness of the skin. The lesions may appear anywhere on the skin surface or on mucosal surfaces. The cause most commonly found is trivalent arsenic compounds. Freezing, cauterization or diathermy coagulation is often effective treatment for Bowen's disease. Bowen disease manifests as a single lesion in two thirds of cases. Lesions may show up on sun-exposed or covered skin. The head and neck are the most frequently affected anatomic locations, followed by the limbs. Lesions differ in size from a few millimeters to several centimeters in diameter. A sharply demarcated, irregular border is usually present. Lesions are erythematous, scaly patches or plaques that can become hyperkeratotic, crusted, fissured, or ulcerated. The lesions are rarely pigmented, especially in the genital region and the nails. Lesions in these locations may appear as melanoma. Bowen disease also may develop on mucous membranes. When these lesions occur on the glans penis, it is referred to as erythroplasia of Queyrat.

Causes

Bowen's disease can be caused by chronic UV radiation. Sun-exposed distribution of Bowen disease (over half of lesions occur on the head, neck, and hands) implicates chronic sun damage as one factor in its formation. Arsenic exposure is another cause. The main sources of arsenic exposure include Gay solution, a medication formerly used to treat asthma; Fowler solution, a medication formerly used to treat psoriasis; and contaminated well water; and certain pesticides. Another cause is the Human papilloma virus. HPV 16 is by far the most common subtype traced from lesions of Bowen disease, although other subtypes, such as HPV 2, also have been found. Other possible causes include trauma, genetic factors, other chemical carcinogens, and x-ray radiation.

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