All Causes, Symptoms and Treatment Bowens Disease

All Causes, Symptoms and Treatment Bowens Disease 

Bowens Disease is a pre-cancerous and neoplastic skin condition, characterized by the development of abnormal scaly or thick patches on the skin mostly as a result of prolonged and frequent exposure to arsenic and sun. The thick patches grow slowly to take a malignant form. The disease was named after Dr John T. Bowen, who was the first to discover it in 1912.

The symptoms of Bowen's disease?

• Bowen's disease is typically a red-looking patch of skin that has an irregular outline. It tends to look crusty or scaly. Sometimes the patch of Bowen's disease can become cracked or ulcerated and can bleed. Patches can slowly enlarge. Patches of Bowen's disease may be a few millimetres in diameter but, in some cases, can grow to several centimetres. Sometimes, in its early stages, Bowen's disease can be mistaken for other skin problems such as ringworm, psoriasis or discoid eczema. The picture shows a typical patch of Bowen's disease on a leg.
• Bowen's disease more commonly appears on areas of the skin that have been exposed to the sun. In about three quarters of cases, it occurs on the leg, below the knee. It may also appear on the neck or face and it may be found under or around nails. It may be found on the palms of hands, on the soles of feet, around the back passage (anus) and in the genital area.
• Bowen's disease-type skin patches that occur on the genital areas may be given some different names. For example, Bowen's disease that occurs on the penis is called 'erythroplasia of Queyrat'.
• Most people just have one patch of Bowen's disease but 1 to 2 people in 10 can have more than one patch at the same time
• If a patch of Bowen's disease starts to become ulcerated, bleeds, or if a small bump appears, this could possibly be a sign that it has started to change into a skin cancer. See your doctor as soon as possible if this happens. Bowen's disease affecting the genitals or anus may be more likely to develop into a skin cancer than Bowen's disease in other places.

The Treatment of Bowens Disease

• Wakeful observation: Bowen’s disease grows very slowly and that only few cases turn into a cancer. Considering the slow growth of the condition it is necessary to become observant through regular check-ups and see if lesion is changing or not. This can be true for the aged patients having lesions on their lower legs where it becomes difficult to ensure healing of the skin after treatment.
• Surgery: Surgery can be appropriate option for removal of small areas under local anesthetic. Surgergical treatment may not be suitable for large areas.
• Curettage and electrocautery: This technique can be adopted to scrap away the area and use heat or electricity for stopping bleeding. Prior to this, a local anesthetic is given to the patient to numb the affected portion of the body. The growth is scrapped away with the use of an instrument called curette having a shape a spoon and then an electrically heated loop or needle is applied in order to check bleeding from the wound and wipe out the remaining abnormal cells. This type of treatment may lead to development of scar with a color different from normal skin color. Curettage can be appropriate for small patches.
• Topical therapy. This type of treatment involves use of a cream, called fluorouracil (5FU) for application to affected area for some time. The patient undergoing this type of treatment usually feels discomfort and inflammation of the affected area. The treatment may alternatively include a drug called imiquimod.
• Radiotherapy: Radiotherapy involves use of a high- energy x-rays for destroying the abnormal cells without affecting normal cells. It can be an effective treatment in case of Bowen’s disease. Radiotherapy can be adopted for those areas where surgery becomes difficult or causes disfigurement.
• Photodynamic therapy (PDT): PDThas emerged as a latest method, which can be adopted for different skin conditions. PDT incorporates the use of laser or light sources and a light-sensitive drug for destroying abnormal cells.
• The treatment starts with application of a photosensitizing cream to the affected portion nearly six hours before the use of light for about 20-45 minutes. Now the affected area is covered with dressing so that it remains unaffected by light. PDT can be more effective for those having large areas of Bowen’s disease.
• Cryotherapy or cryosurgery: This type of treatment involves
• spraying of liquid nitrogen on the affected area. This is done mainly to freeze the affected area. Use of liquid nitrogen in has been found to be effective in ensuring quick recovery. This treatment can be better for small or flat lesions.