Bowen’s disease is characterized by the development of one or more precancerous skin lesions. These appear as scaly patches, irregular and red to brown in color. Several treatments can be considered depending on the case.

Definition of Bowen’s disease

Bowen’s disease is a form on-site of cutaneous squamous cell carcinoma. It is also presented more simply as an intra-epidermal cancer. As a reminder, the epidermis is the surface layer of the skin.

Bowen’s disease is characterized by the appearance of precancerous skin lesions. These lesions are not accompanied by any other clinical signs. They appear as scaly patches with irregular outlines and red-brown in color.

Usually multiple, lesions spread slowly. Appropriate management helps prevent their development and limit the risk of complications. Although it is low, there is a risk of progressing to skin cancer or invasive squamous cell carcinoma. This risk is estimated at 3%.

Causes of Bowen’s disease

As with many tumors, Bowen’s disease has an origin that remains poorly understood to this day. However, research has identified some risk factors that may help better understand the development of Bowen’s disease.

Bowen’s disease risk factors

The risk factors identified to date are:

• solar irradiation due to excessive exposure to the sun;
• poisoning with arsenic compounds;
• human papillomavirus (HPV) infections;
• l’immunodépression.

People affected by Bowen’s disease

Bowen’s disease is usually diagnosed in people over the age of 60, and especially in those in their XNUMXs. It seems that this disease mainly affects women.

Bowen’s maladie diagnosis

A clinical examination shows the extent of the lesions. The diagnosis of Bowen’s disease requires a biopsy, the removal of tissue for analysis.

Skin lesions

Bowen’s disease is characterized by the appearance of lesions on the skin. Although these can appear on any area of ​​the body, they usually appear on parts of the body exposed to the sun.

Skin lesions have the following characteristics:

• scaly appearance;
• irregular contours;
• usually multiple plaques;
• red to brown coloring
• possibility of evolution towards crusts.

The appearance of these lesions may resemble patches of eczema, psoriasis, or a fungal skin infection. A thorough diagnosis is therefore essential.

Possible lesions of the mucous membranes

It was observed that lesions could appear on certain mucous membranes, in particular on the vulva and the glans.

Mucosal lesions can be:

• pigmented;
• erythroplastic, with the appearance of an abnormal red area or a set of red spots;
• leukoplakic, with the formation of an abnormal whitish area.

Possible nail lesions

Damage to the nails can also occur. These are manifested by localized longitudinal erythronychia, that is, a red band that surrounds the nail.

The management of Bowen’s disease involves removing the affected cells. For this, several techniques can be considered depending on the case. For example :

• topical chemotherapy with the use of anticancer drugs in the form of cream, lotion or ointment;
• electrodesiccation with the use of an electric current to remove specific skin lesions;
• surgical excision which involves the removal of precancerous tissue;
• cryosurgery, or cryoablation, which uses cold to freeze and destroy abnormal cells.

It is recognized that exposure to ultraviolet (UV) rays is a significant risk factor for skin cancer. That is why it is recommended to:

• limit sun exposure by favoring shaded areas, minimizing outdoor activities during hot hours (from 10 a.m. to 16 p.m.) and limiting sunbathing;
• use suitable protective clothing when sun exposure is unavoidable such as long-sleeved shirts, pants, wide-brimmed hats and sunglasses;
• apply a sunscreen with an index of protection against UVA / UVB greater than or equal to 30, and repeat its application every 2 hours, after swimming or in the event of excessive sweating;
• avoid using tanning booths.