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Bowen's disease

Bowen's disease is a common skin condition which usually begins in later life.  It results in a red, scaly patch on the skin and can be mistaken for a rash, eczema or psoriasis. It's caused by the abnormal growth of cells in the outer layer of the skin (epidermis) and is a very early form of squamous cell skin cancer which is easily curable.

Bowen's disease is also called squamous cell carcinoma in situ.

Occasionally, in about three to five people out of every 100 who have Bowen's disease, it can invade the deeper layers of the skin and if left undiagnosed and untreated, can turn into a type of skin cancer which can spread to other parts of the body.

How do you get Bowen's disease?

In many cases the cause is unknown but we do know it doesn't run in families, isn't infectious and isn't due to an allergy.

Long-term over exposure to the sun (especially among fair skinned people) is probably the most important risk factor but it can occur in areas that haven't been exposed to the sun. Previous radiotherapy (for a different cancer) in the affected area is another risk factor, as is exposure to arsenic or engineering oils, although this is very rare. It's also more likely to affect people who take medication to suppress their immune system (for example, those who have just had an organ transplant).

Occasionally, Bowen's disease can affect the genital area. This is usually linked with the human papilloma virus ( HPV). There are different types of this common virus and some are linked with cancers, such as cervical cancer.

Bowen's disease is more common in women, and it usually affects people over 60.

Symptoms and diagnosis of Bowen's disease

Bowen's disease can grow anywhere on the body but it commonly occurs on sun-exposed skin, especially the head, hands and lower legs.

To begin with it looks like a red, scaly patch (1-3cm across) or sometimes like raised spots or warts. The affected skin can become itchy and sore, and may bleed and scab.

Bowen's disease is often diagnosed simply by its appearance to the naked eye. This can be confirmed by taking a sample of skin ( biopsy). This is usually done by a dermatologist (specialist in skin diseases).  A local anaesthetic is given to numb the area and a small part of the affected skin is removed. The sample is then sent for examination at a laboratory where it will be looked at under a microscope.

What is the treatment for Bowen's disease?

There are a number of different treatments available for Bowen's disease depending on where it is on your body, the size, thickness and the number of patches.

How well the skin is likely to heal afterwards will also be taken into consideration. For example the skin on the lower legs tends to be tight and more fragile (especially in older people) and as a result, there may be problems with it healing.

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