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Bowen’s Disease, or Squamous Cell Carcinoma in situ, is a skin cancer found in the outermost layer of the skin. It is generally considered a precursor to invasive Squamous Cell Carcinoma, and should not be ignored. Bowen’s disease is not considered an indolent tumor and requires treatment to ensure it does not spread, invade local structures or spread beyond the skin.
Bowen’s Disease typically appears as an expanding pink to red patch of skin, that grows slowly over time. Like many skin cancers, Bowen’s Disease can have irregular borders, scaling and/or crusting. Bowen’s Disease can develop anywhere on the skin, but is common on chronically sun exposed areas including the lower leg area. Bowen’s Disease often appears irritated and is often confused with a patch of eczema or ringworm – all of these can be red, scaly, or crusted. The difference is Bowen’s Disease doesn’t go away when you treat it with a cortisone or antifungal cream. The cancer will persist, despite these treatments.
It is important to keep track of the spots on your skin. Get to know your skin. If you see something more severe than the usual scratch, if you have a sore that doesn’t heal, or an irritation that persists despite treating it with a cream or ointment, it is important that you get it checked out. This ‘early stage’ skin cancer can grow and invade, becoming a much bigger problem.
Bowen’s Disease is managed similarly to other non-melanoma skin cancers. There are a variety of treatments available for this condition. Topical chemotherapy with 5-fluorouracil has been used for these tumors, as has photodynamic therapy. Destructive therapies with liquid nitrogen or electrodessication and curettage can also be used. The downside of these therapies, if there is one, is the lack of margin control. That is, if you want to ensure you completely remove a cancer from the body, you want to check the tissue or margins around the cancer to make sure no atypical cells are left behind. Unfortunately, the topical, light-based and destructive therapies don’t tell you if you have clear margins. Surgical management of Bowen’s disease with excision or Mohs Micrographic Surgery can rid the body of the dangerous cells while telling you the margins can clear of cancer.
Irregular patches, marks, or moles on the skin can be signs of skin cancer, and it is always important to act if you notice a change or something new. The American Academy of Dermatology recommends yearly skin checks for all individuals to help detect skin cancers early, before complications arise.
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If you have additional questions about Bowen’s Disease, or if you are concerned about any of your moles or skin changes, please contact us today at Sanova Dermatology.