Bowen's disease, or squamous cell carcinoma in situ, is a type of skin cancer. In situ means the condition manifests on the surface of the skin. The condition is more common in women than in men, and it generally manifests in older adults. The disease is named after Dr. John T. Bowen, who first discovered the cancer in 1912.
Patients with Bowen's disease typically exhibit red, scaly patches on the skin. Symptomatic areas may itch or crust over, though most of them do not cause any type of pain or irritation. Doctors usually perform biopsies on affected areas of skin to determine whether the red patches are from Bowen's disease or another less harmful skin condition, such as eczema or psoriasis.
Chronic overexposure to the sun and aging are the two most common causes of Bowen's disease. The sun's ultraviolet rays damage the upper layers of skin over time, making people who spend a lot of time in the sun without protection more susceptible to skin cancer. Human papillomavirus, or HPV, increases the risk of developing squamous cell carcinoma in situ. Arsenic poisoning also contributes to internal and skin cancers, though it is rare.
The most common treatment method for Bowen's disease is surgical removal of the affected areas. Doctors cut away the top layers of skin that show symptoms of the disease, as well as a small portion of skin around the border of the symptomatic area. Many people who undergo this treatment have no further problems with the cancer.
In some cases, doctors use lasers or liquid nitrogen to burn off areas affected by the condition. Burning methods are typically reserved for patients who cannot undergo surgery due to a medical condition. The treated areas usually heal well, although scar tissue forms on the skin.
Efudex® and Aldara® creams can heal areas affected by the cancer over several months. These treatments often leave the skin raw and irritated, but they are helpful for patients with multiple affected areas. People with multiple spots that need to be treated may also undergo radiation treatments to destroy cancer cells.
Patients diagnosed with Bowen's disease must undergo regular skin evaluations by a dermatologist since being diagnosed with the condition increases the risk of developing other skin cancers. Prompt treatment of the cancer is vital. The affected areas spread and grow larger over time if left untreated. While rare, the cancer can progress to invasive squamous cell carcinoma if it is not treated.