Bowen Disease (BD)
Bowen Disease (BD): Symptoms, Causes, Diagnosis, and Management
Bowen Disease (BD) is a premalignant skin condition, also known as squamous cell carcinoma in situ, characterized by red, scaly patches on sun-exposed areas. It is a slow-growing cancer confined to the epidermis, the outermost layer of the skin. Below is a detailed overview of its key aspects, supported by current evidence.
Symptoms
Bowen’s disease typically presents as:
- Red, scaly patches with irregular edges, often flat or slightly raised.
- Crusty or ulcerated in some cases.
- Itching, soreness, or bleeding are less common but may occur if irritated.
- Lesions can appear anywhere but are most common on the lower legs, face, neck, and hands[1][2][3].
Genital involvement: May manifest as bowenoid papulosis or erythroplasia of Queyrat, with symptoms like ulcers or discharge[2][6].
Causes and Risk Factors
Primary Cause:
- Chronic UV exposure: Long-term sun damage is a major risk factor, though it can occur on non-sun-exposed areas[5][6].
Other Risk Factors:
- HPV infection: Specifically, HPV 16 is linked to bowenoid papulosis[6].
- Arsenic exposure: Prolonged contact with contaminated water[6].
- Immune suppression: Conditions like AIDS or post-transplant immunosuppression increase risk[6].
Diagnosis
Clinical Examination:
- Visual inspection: Lesions are identified based on their appearance and persistence.
- Biopsy: Confirms diagnosis by showing cancer cells confined to the epidermis[5].
Differential Diagnosis:
Treatment
Topical Therapies:
- Imiquimod cream: Stimulates immune response against lesions.
- Chemotherapy creams (e.g., fluorouracil): Applied directly to the affected area.
Destructive Methods:
- Cryotherapy: Freezing with liquid nitrogen.
- Photodynamic therapy (PDT): Uses light-sensitive drugs to target lesions.
Surgical Options:
- Excision: For large or resistant lesions.
- Radiotherapy: In some cases, especially for sensitive areas[6].
Prognosis
- With treatment: High cure rates due to its non-invasive nature.
- Untreated: Small risk of progression to invasive squamous cell carcinoma, especially in immunocompromised individuals[4][6].
Conclusion
Bowen’s disease is a treatable pre-cancerous condition requiring early diagnosis and intervention to prevent progression. Regular skin checks and sun protection are crucial for managing and preventing Bowen’s disease.
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At DrStemCellsThailand (DRSCT)‘s Anti-Aging and Regenerative Medicine Center of Thailand, we emphasize comprehensive evaluations and personalized treatment plans of Cellular Therapy and Stem Cells for managing various health conditions. If you have questions about Bowen Disease (BD) or would like more information on our services, consult with our experts today!
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