SKIN CANCERS & CONDITIONS
Bowen’s disease (squamous cell carcinoma in situ)
Bowen’s disease is a slow-growing skin cancer, often resembling a rash. Multiple treatments are available.
- Also known as intraepithelial carcinoma (IEC)
- May appear as a pink scaly patch
- Non-surgical treatment options
Bowen’s disease, also known as squamous cell carcinoma in situ, superficial squamous cell carcinoma or intraepithelial carcinoma (IEC), affects the upper layers of skin and appears as a red, rough, scaly patch rather than a lump.
There may be a rough, raised crust on the surface. It usually grows very slowly, spreading out sideways rather than extending deeper into the skin. The patient may have difficulty noticing changes occurring and so it may take a long time to diagnose.
What does Bowen’s disease look like?
Bowen’s disease is usually flat, red and dry. This appearance and behaviour are similar to many other conditions, including dermatitis, psoriasis and some fungal infections. It most often appears in areas that have experienced sun exposure over many years, such as the face, ears, scalp, hands and forearms and lower legs. Sometimes, Bowen’s disease is an irritated or ulcerated patch of skin that fails to heal over many months.
MBBS, MA (Virtual Comm), Grad Cert Hlth Info, Grad Dip Comp Inf Sci
Bowen's disease/intraepithelial carcinoma/squamous cell carcinoma in situ on the arm. The appearance in this case is pink and slightly raised.
On the temple of an elderly man. Inflamed and irritated with a crusted surface.
Bowen's disease with an irregular shape and fine scale
Bowen's disease with an irregular shape and smoother surface.
Diagnosis
Bowen’s disease may be suspected if an irregular pink rough patch appears on a sun-exposed part of the body, particularly in an elderly patient or one with a suppressed immune system. A punch or shave biopsy may be necessary to confirm the diagnosis.
Risk factors
SSCC is the second most common type of skin cancer after basal cell carcinoma. It is more common in people with fair skin, a history of sun exposure over many years, or those with immunosuppressive conditions.
Other risk factors include human papillomavirus (HPV) infection and smoking.
Progression
If untreated, Bowen’s disease can eventually develop into more invasive squamous cell carcinoma. This is estimated to happen in about 5 to 10% of cases. Squamous cell carcinoma is normally able to be treated successfully, but some cases can spread to other body organs causing serious illness or death.
Treatment of Bowen’s disease
Bowen’s disease is usually easy to treat. Because it affects the surface layers of the skin, topical treatments are effective and may be preferred in cases where a good cosmetic outcome is desired, or surgery is inappropriate.
Other treatments include excision, cryotherapy and photodynamic therapy.
Learn about other non-surgical treatments for skin cancers.
After a diagnosis of Bowen's disease
Regular check-ups will help detect new skin cancers
Check your skin regularly for signs of skin cancer. Be alert for “ugly duckling” spots that don’t resemble your other spots or moles.
Due to a higher risk of skin cancers in future, including potentially serious squamous cell carcinomas, have a yearly full body skin check with an experienced skin cancer doctor.
Even if you’ve already been diagnosed with skin cancer, it’s not too late to reduce your risk. Wear sunscreen whenever the UV index is over 3, cover up with long sleeves, sunglasses and a hat, and stay in shaded areas when possible.
Treatments for Bowen’s disease
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