Bowen's disease is a form of non-invasive skin cancer. This means that the cancer is limited to the basal membrane of the epidermis, but if left untreated, it may begin to move to deeper tissues and even metastasize to lymph nodes and to distant organs, such as bones and the brain. What are the causes and symptoms of Bowen's disease? What is the treatment?
Bowen's diseaseis a pre-invasive form (i.e. the form ofin situ )squamous cell carcinoma -malignant squamous epithelial tumor.
The disease in most cases affects people over 60 (in 80% of cases) and is slightly more common in women.
The formin situ(meaning "in place") means that cancer is limited to its primary focus, i.e. to the basement membrane cuticle. However, if left untreated, it can turn into invasive skin cancer - that is, cancer that begins to attack deeper tissues. It can even metastasize to lymph nodes and to distant organs such as the bones and the brain. The risk of turning Bowen's disease into an invasive form of squamous cell carcinoma is 3%. and usually it is a multi-year process.
Bowen's disease - causes and risk factors
The risk of developing Bowen's disease is increased by:
- chronic exposure to solar radiation
- long-term contact with carcinogens (especially arsenic)
- human papillomavirus infections (especially HPV-16)
- immunosuppression
- chronic skin diseases
Bowen's disease - symptoms
Bowen's disease manifests itself as erythematous changes which:
- are clearly demarcated
- covered with scabs
- in the middle may be cracked, warty or less often pigmented
- can be single or multiple
- slightly protruding above the level of the surrounding skin
- ulcers may occur
- are usually located on the head, neck and torso (mainly in areas exposed to sunlight) - when the changes affect the glans penis or labia, it is called Queyrat erythroplasia
Any enlargement of the lesions, increased infiltration of the base and increased decay indicate neoplastic transformation.
Bowen's disease-recognition
If Bowen's disease is suspected, dermatoscopy is performed. The final diagnosis is made on the basis of a histopathological examination. This image shows numerous, often abnormal dividing figures and a thickened epidermis with marked distortion.
Bowen's disease-treatment
The treatment of Bowen's disease includes cryotherapy, surgical removal of the lesion, CO laser treatment2 , photodynamic therapy, 5-fluorouracil cream, 5% imiquimod cream.