Bowen's Disease

Bowen's disease is a precancerous skin disorder that causes skin plaques or patches that might be precancerous in some people. This condition occurs when abnormal cells grow in the skin's outer layer in the affected area. Because this condition can develop into skin cancer, treatment and a close follow up are usually advised. Dermatologists in Gainesville with Gainesville Dermatologist & Skin Surgery offer treatments for various skin conditions, including Bowen's disease. Contact our Gainesville dermatologists today to schedule a dermatology appointment and to learn more about our available treatments.

What Is Bowen's Disease?

Bowen's disease is a rare skin disorder in which slow-growing, reddish, scaly patches or plaques develop on the skin. These lesions develop due to skin cell changes affecting the epidermis or the outermost skin layers. These patches are considered the earliest form of squamous cell skin cancer. Bowen's disease closely resembles actinic keratosis (AK), another precancerous skin condition characterized by rough, scaly, red lesions on the skin.

The main difference between AK and Bowen's disease is Bowen's disease patches tend to be larger than AK lesions. Sometimes referred to as squamous cell carcinoma in situ, Bowen's disease, if not treated, can occasionally develop into squamous cell carcinoma (SCC), a common curable form of skin cancer that affects the outer layer of the skin but can spread to deeper layers. Sun exposed areas of the skin are most affected.

Symptoms Of Bowen's Disease

Bowen's disease causes an individual to develop slow-growing skin lesions, among other Bowen's disease symptoms. These skin lesions may appear as red or brown patches or dry, scaly plaques. The patches may bleed, ooze pus, itch, or feel tender to the touch. Due to the plaque's appearance, Bowen's disease can resemble other skin conditions, including eczema, fungus, psoriasis, and other skin rashes. While many people with Bowen's disease develop a patch, some people have more than one skin lesion at one time. The patch may be red, brown or pink, scaly or crusty, flat or raised, be up to multiple centimeters across, and occasionally itchy or uncomfortable.

The patch can appear anywhere on the skin, especially in areas exposed to the sun, such as the lower legs, neck, and head. Occasionally, these lesions can appear in the groin area and on the penis. If the lesion bleeds, turns into an ulcer or open sore, or if it develops a lump, it may indicate the presence of squamous cell skin cancer. If you suspect you have Bowen's disease, contact your dermatologist promptly for a check-up.

Is Bowen's Disease Serious?

In many situations, Bowen's disease itself is not serious. It tends to develop slowly, over months or even years, and there are several effective treatments for it. However, the primary concern is that this condition can eventually develop into squamous cell carcinoma if left neglected, untreated, or undiagnosed.

In many cases, squamous cell skin cancer can be treated, though it can spread deeper into the body and pose a serious hazard to health. For this reason, a person with Bowen's disease should be aware of the signs that a skin lesion might be cancerous. These signs may include, but are not limited to, hardening of a skin lesion, a nodule that's tender, a flesh-colored lump or nodule, and a skin nodule that is easy to bleed.

If you notice these or any other changes to your skin, you should see a dermatologist right away. For more information about the severity of Bowen's disease, contact our office.

Bowen's Disease Causes

The exact cause of Bowen's disease is unknown, however, several different risk factors may increase your likelihood of developing this condition, including the following.

Aging

Chronic Arsenic Exposure

Significant Sun Exposure

Long-Term Sun Exposure

The Use Of Tanning Beds

Previous Radiotherapy Treatment

Immunosuppression

Infection With HPV

Previous Injuries To The Skin

Inflammatory

Who Develops Bowen's Disease?

Bowen's disease seems to occur more frequently in women than in men. This condition most commonly affects individuals 60 years of age and older, and it is more common in people with light, fair, or white skin and on parts of the body where the skin has sustained exposure to the sun. Individuals may also be more likely to develop Bowen's disease if they previously had non-melanoma skin cancers, including basal cell carcinoma and squamous cell carcinoma. These skin cancers are not malignant melanoma. Individuals are also at an increased risk of developing non-melanoma skin cancers if they have Bowen's disease. This is thought to be due to excessive sun exposure being a pertinent risk factor for Bowen's disease and non-melanoma skin cancers.

How Is Bowen's Disease Diagnosed?

Bowen's disease is generally suspected by its characteristic appearance on the skin, such as the presence of typically Bowen's disease lesions. During your appointment, your dermatologist will examine your skin and may be able to diagnose this skin condition based on its appearance alone. They may also take a sample of your skin to confirm their diagnosis.

This sample is known as a biopsy. Before a biopsy is taken, your doctor will numb the area using a local anesthetic. Once the area is sufficiently numbed, the dermatologist will remove a small piece of the affected area of skin and then examine it under a microscope.

Bowen's Disease Treatment

WDermatologists consider several factors when treating Bowen's disease. These factors include the location of the lesion or lesions, their appearance, their size and thickness, the number of areas affected, any previous treatments performed for Bowen's disease, and the patient's overall health and age. Each available treatment option has different benefits and varied risks. As such, the exact treatment that a patient receives is specific to them and their health needs. Doctors don't always recommend treating Bowen's disease lesions as they may not be problematic or slow-growing. If a patient has other conditions that may affect their ability to heal properly following a treatment, their doctor may recommend waiting to see how Bowen's disease develops before pursuing treatments for it.

Available treatment options may include the following. For more information, please contact Gainesville Dermatology & Skin Surgery.

Cryotherapy. This treatment involves applying a freezing substance, such as liquid nitrogen, to destroy the Bowen's disease skin cells.
Curettage. This surgical procedure uses special medical tools to burn the lesion and then scrape it away from the surrounding, healthy skin.
Surgical Removal. This treatment method involves removing the lesion through surgery and then closing the incision. Mohs micrographic surgery may help preserve tissue.
Photodynamic Therapy (PDT). During PDT, a dermatologist applies a special drug to the lesion or lesions. The drug reacts to light exposure and the skin cells are destroyed.
Topical Chemotherapy. Topical chemotherapy medications or immunotherapy creams may be used to treat Bowen's disease.
Radiotherapy. This treatment uses high-energy X-rays to treat abnormal cells. It may be used in patients with symptoms such as pain or bleeding from their Bowen's disease.
Laser Treatment

Can Bowen's Disease Be Prevented?

Minimizing your exposure to the sun can help reduce your likelihood of developing Bowen's disease. However, individuals who do not have a significant history of sun exposure can still get Bowen's disease. To help reduce your likelihood of developing this and other sun-related skin conditions, we recommend practicing the following.

Do not use tanning beds
Avoid working or remaining outdoors under direct sunlight
Wear protective clothing when outdoors, including sun-protective clothing (UPF) and wide-brimmed hats
Apply sunscreen daily and reapply it regularly frequently
Choose a sunscreen with a sun protection factor (SPF) of at least 35
Limit sun exposure, whenever possible