Also called squamous cell carcinoma in situ. Affects
squamous cells (the outermost skin cells in the epidermis). Considered precancerous,
with about 10% of cases becoming invasive squamous cell carcinoma.
Mostly affects Caucasians over 60. It is believed
to affect men more than women.
Bowen's disease is neither contagious nor related to allergies.
Although it is often mistaken for psoriasis or eczema. It can also
resemble superficial basal cell carcinoma, actinic keratosis, seborrheic keratosis,
lichen planus, tinea corporis and extramammary Paget'sdisease. A biopsy can
will give a definitive diagnosis of BD provided a deep enough sample is taken
to distinguish it from basal cell carcinoma.
Causes / Factors increasing risk of getting Bowen's disease
Most often affects areas of skin with chronic sun exposure.
However, can also occur in places where the sun doesn't usually shine.
People with fair skin seem to be more vulnerable.
Aging
Immunosuppression. More likely in those with a compromised
immune system or those taking immunosuppression drugs.
Having a cutaneous human papillomavirus (HPV) infection.
HPVs are a group of more than 150 related viruses. HPV 16 (most
commonly), 18, 34, and 48 have caused Bowen disease at genital sites. HPV 16
is also the cause of some cases of cervical cancer. Less often, HPV types 2,
16, 34, and 35 are associated with Bowen disease in areas of the body other
than the genitals.
Chronic arsenic exposure. Usually about 10 years
after initial exposure. Arsenic is a tasteless, colorless metallic element
that has been known to contaminate well water in the past.
Symptoms of Bowen's disease
Most often occurs on lower legs. Can also appear on head, neck,
palms and genitals.
Slow-growing, reddish-brown, flat or slightly raised patch of dry, scaly
skin. Size ranges from a few millimeters to a few centimeters.
Can itch, ooze pus, bleed or become crusted and/or tender.
Lesions may be warty (verrucous), split open (fissured) or, less often,
darkly colored (pigmented).
Typically there is only one lesion, but multiple lesions may develop in
10-20% of cases, usually in more than one area of the body.
Early signs of malignant transformation in Bowen's disease include:
The development of a fleshy nodule or bump in a skin lesion. This
nodule may be tender and bleed easily.
Treatments for Bowens disease
Alternative treatment choices to directly destroy cancer cells
Topical eggplant extract. Used since 1825, eggplant
extract has been shown to be effective in the treatment of both malignant and
benign human skin tumours. Solasodine rhamnosyl glycosides (BEC) can be extracted
from eggplants. A preparation (Curadermâ„¢) which contains 0.005%
BEC is effective in the treatment of keratoses, basal cell carcinomas (BCCs)
and squamous cell carcinomas (SCCs) of human skin.
Link
Topical myrrh and frankincense essential oils. DIluted
in carrier oil and rubbed on lesions shown effective against skin cancers. Myrrh
is rich in sesquiterpenoid and curzerene. Frankincense has several active ingredients.
Link
Common mainstream treatments for Bowens disease
Topical chemotherapy. Two common creams are 5-fluorouracil
and imiquimod 5%, applied directly to lesions twice daily for two weeks or much
longer to directly destroy the cancer cells.
Curettage. The lesion is scraped off the skin under anaesthesia,
possibly followed by cauterization.
Surgical removal. Lesion is cut out and sutured (leaves
scar)
Cryotherapy. Uses extreme cold to freeze and destroy tissue
and cells of skin lesions. Most effective for single or small lesions.
Photodynamic therapy (PDT). A photosynthesizer drug is
absorbed by affected cells aalong with a specific wavelength of light to activate
the drug producing a chemical to destroy affect cells. Useful for large lesions.
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