Bowen’s disease in the distal phalanges

Syn.: Digital Bowen’s disease, digital epidermal carcinoma.

Def .: Squamous cell carcinoma in situ occurring in the periphery of the distal phalanges.

Epid .: Changes usually occur in the elderly.

Etiol .: It is a rare disease that previously occurred in, among others, radiologists who were exposed – in the absence of adequate protection – to the exposure of their fingers to x-rays.

Localization: A typical location of Bowen’s disease in the toe area is the toenails and toes.

Clinical: Initially, it is a slight erythema and (with placenta involvement) the separation of the nail plate, followed by a slowly developing tumor and ulceration.

Hist .: Histopathological examination reveals the presence of atypical keratinocytes in all layers of the epidermis. Also present are dyskeratotic cells as well as polynuclear and mitotic cells. The hallmark of Bowen’s disease, which is an in situ carcinoma, is that the tumor does not cross the basement membrane and does not infiltrate the dermis, which distinguishes it from squamous cell carcinoma that progresses from Bowen’s disease.

DL: Diagnostics are based on a biopsy and histopathological examination of the collected material.

DR: Bowen’s disease should be differentiated from other, slowly growing tumors in this area. The histopathological examination is decisive.

Treatment: Treatment consists of surgical removal of the lesion.

Year: Change develops very slowly and is completely curable in the initial period. If left untreated, true squamous cell carcinoma, which is very rare in this area, develops further.

DIG. C-10. Bowen’s disease. Fire on the back of the fifth finger of the right hand with the presence of erosions and scabs.

Lit.: [1] Sau P., MacMarlin S.L., Sperling L.C. i wsp.: Bowen’s disease of the nail bed and periungual area. A clinicopathologic analysis of seven cases. Arch Dermatol, 1994, 130; 204-209.

Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House

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