Bowen's Disease

Definition

Bowen's disease is medically the same as "squamous cell carcinoma in situ." Squamous cell carcinoma is a tumor that develops from the squamous cells which are flat, scale-like cells in the outer layer of the skin. Bowen's Disease is an abnormality of skin with scaly or thickened patches on the skin and often caused by prolonged exposure to arsenic. It is usually characterized by a precancerous, slow growing skin malignancy.

The hallmark of Bowen disease is a persistent, progressive, slightly raised, red, scaly or crusted plaque. The patches often occur on sun-exposed areas of the skin and in older, white men. These patches may sometimes become malignant (cancerous) too. Also called pre cancerous dermatosis or pre cancerous dermatitis.

Causes of Bowen's Disease

The Possible Causes of Bowen's Disease includes:-

• Other possible causes of bowen's disease include - genetic factors, trauma, other chemical carcinogens, and x-ray radiation.
• Ionizing radiation: The ionizing radiation may also affect the skin pigmentation, which may lead to bowen's disease.
• Gender - The bowen's disease is more common in women.
• A long-term Sun Exposure is one of the main cause of bowen's disease.
• Wrinkles, changes in Pigmentation, and loss of Elasticity in your skin may also also lead to the bowen's disease.
• Age - Bowen's Disease is a condition which is more common in people above age of 40 years.
• Immunosuppression from drugs such as ciclosporin or azathioprine. The longer the course, the more likely that skin cancer will arise, especially in sun-damaged skins.
• The skin area, which is affected by the x-ray radiations, may lead to bowen's disease.
• Arsenic Exposure: The main sources of arsenic exposure include Fowler solution, a medication formerly used to treat psoriasis; Gay solution, a medication formerly used to treat asthma; contaminated well water; and certain pesticides.

Symptoms of Bowen's Disease

Symptoms of Bowen's Disease include:

• Skin cancer, may be the symptom of bowen's disease in chronic condition.
• Any site may be affected, although involvement of palms or soles is uncommon.
• The patches can be single and in groups. The edges of each patch are irregular but distinct from the surrounding skin.
• The plaque within or on the skin may be seen in bowen's disease.
• Bowel's Disease may occur at any age in adults but is rare before the age of 30 years - most patients are aged over 60.
• The pinkish or brownish raised areas of skin are due to bowen's disease.
• There will be wart-like growth in the skin and bleeding may occur.
• Bowen's disease usually appears as a red scaly patch often on the legs. There may be more than one patch.
• The patch or patches grow very slowly.
• The patches grow very slowly and, while they can be a nuisance, they do not cause any serious harm.
• The patches can affect any part of the body, but are most common at lower leg.
• Open sore that bleeds and crusts can also be seen with bowen's disease and it persists for weeks.

Treatments of bowen's disease

The Effective Treatments for Bowen's Disease are as:-

• Radiotherapy: The X-Ray treatment can be used for some skin cancers, appearing on the face.
• 5-Fluorouracil Cream: This cytotoxic cream applied may be applied for several weeks on the affected area.
• Curettage - The lesion is scraped off the skin. It may also be used with cauterisation, where the skin is lightly burnt with and electric current. Recurrence is slightly more likely than with surgery.
• Liquid Nitrogen - The treatment of bowen's disease with liquid nitrogen is found very effective for fast recovery. This may be suitable for small or flat lesions.
• Cryosurgery - In this technique, lesion is destroyed with intense cold. This type of treatment has a high success rate.
• Photodynamic Therapy - A special type of light is used to destroy the lesion.
• Combination therapy - In many cases, the patient undergoes two or more forms of treatment, depending on their individual needs.