Bowen’s Disease: Causes, Symptoms, Diagnosis, Treatment, and Prevention
A skin condition called Bowen's disease causes red, scaly patches to develop on the skin due to abnormal changes in the epidermis, which is the outermost layer of the skin. This blog post will discuss Bowen’s disease's causes, symptoms, diagnosis, treatment, and prevention. It is considered to be the earliest form of squamous cell carcinoma (SCC).
Causes of Bowen’s Disease
The exact cause of Bowen’s disease is unknown, but there are some factors that may increase the risk of developing it. These include:
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Chronic exposure to ultraviolet (UV) radiation from the sun, tanning beds, or some artificial lights
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A weakened immune system due to certain diseases, medications, or treatments
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A history of human papillomavirus (HPV) infection, especially strains 16, 18, 34, and 48
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Chronic exposure to arsenic, which may be present in contaminated well water or some industrial areas
Bowen’s disease is more common in people over the age of 60 and in those with fair skin and significant sun exposure.
Symptoms of Bowen’s Disease
The main symptom of Bowen’s disease is a single or multiple red, scaly patches or plaques on the skin. These patches may also:
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Bleed or ooze pus
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Itch or be tender to the touch
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Have well-defined borders
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Grow slowly over time, ranging from a few millimeters to a few centimeters in size
In addition to the head, neck, chest, back, arms, and legs, the patches can also affect the genitals or the anus, in which case they are called Bowenoid papulosis or erythroplasia of Queyrat.
The patches of Bowen's disease can resemble other skin conditions, such as eczema, psoriasis, or fungal infections. Therefore, it is important to see a dermatologist for a proper diagnosis.
Diagnosis of Bowen’s Disease
A dermatologist will examine the skin and take a small sample of the affected area (a biopsy) for microscopic examination. The biopsy will show abnormal cells in the epidermis, which are characteristic of Bowen's disease.
Sometimes, the dermatologist may also perform other tests, such as:
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A blood test to check for HPV infection or other diseases that may affect the immune system
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A skin scraping or culture to rule out fungal or bacterial infections
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An imaging test, such as an X-ray, to check for arsenic exposure or internal organ damage
Treatment of Bowen’s Disease
It is important to consider several factors when treating Bowen’s disease, including the patient’s age, health, and preferences, as well as the location, size, number, and appearance of the patches. The main goal of treatment is to remove or destroy the abnormal cells and prevent them from becoming invasive cancer cells.
Some of the treatment options for Bowen’s disease are:
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This is the most effective and definitive treatment, but may leave a scar or need skin grafting. Surgery involves excising the patch and a small margin of normal skin around it.
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It is a simple and quick procedure, but it may cause pain, blistering, or discoloration of the skin.
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Curette and electrodessication, in which a sharp instrument is used to scrape off the patch and an electric current is applied to stop the bleeding and destroy the remaining cells. The procedure is relatively fast and inexpensive, but it can also result in scarring or infection.
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It involves applying creams or gels containing chemicals or drugs that kill abnormal cells or stimulate the immune system to fight them. Some of these medications are 5-fluorouracil, imiquimod, diclofenac, or ingenol mebutate. Despite their ease of use and minimal side effects, these treatments can take several weeks or months to work and may cause irritation, inflammation, or allergic reactions.
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A light-sensitive substance is applied to a patch, which is then activated by a special light that destroys the abnormal cells. Despite being a relatively new and promising treatment, it may be expensive, require multiple sessions, and cause pain, swelling, or redness in the skin.
The choice of treatment may depend on the availability, cost, and effectiveness of each option, as well as the patient’s preference and tolerance. For better results, a combination of treatments may be used. During the consultation, the dermatologist will discuss the pros and cons of each option, and help the patient make an informed choice.
Prevention of Bowen’s Disease
The best way to prevent Bowen’s disease is to avoid or reduce the exposure to the risk factors that may cause it. These include:
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Protecting the skin from the sun by wearing sunscreen, hats, sunglasses, and clothing that covers the exposed areas
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Avoiding tanning beds or other sources of artificial UV radiation
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Getting regular check-ups and screenings for HPV infection and other diseases that may weaken the immune system
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Avoiding or limiting the intake of arsenic, which may be present in some foods, water, or medications
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Quitting smoking, which may increase the risk of skin cancer and other health problems
Furthermore, it is important to seek medical attention as soon as possible if you notice any changes or signs of Bowen’s disease, such as new or growing patches on your skin. It is possible to improve the prognosis and quality of life of Bowen's disease by detecting it early and treating it effectively.
Summary
Due to abnormal changes in the epidermis, Bowen’s disease causes red, scaly patches to appear on the skin. These patches are considered to be the earliest form of squamous cell carcinoma. The diagnosis of Bowen’s disease can be made by performing a skin biopsy, which shows the presence of abnormal epidermis cells. It is caused by chronic sun exposure, HPV infection, or arsenic exposure. Treatments include surgery, cryotherapy, curettage and electrodessication, topical treatments, and photodynamic therapy. Getting regular checkups and screenings, monitoring the skin for changes, avoiding or reducing exposure to the risk factors, and protecting the skin from the sun are all part of preventing Bowen's disease. Despite being a treatable and curable condition, Bowen's disease must be treated and cared for promptly in order to prevent invasive cancer from developing.
