What is Bowen disease?

Updated: Jan 30, 2020
  • Author: Ginard I Henry, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Originally described by Bowen in 1912, these lesions predominantly involve skin that is not exposed to the sun (ie, protected). Classically, Bowen disease, also known as carcinoma in situ and squamous intraepidermoid neoplasia, involves the genitalia. Itching is a common symptom. With vulvar involvement, the labia majora tend to be involved more than the labia minora. The lesions are scaly, crusted, erythematous plaques. This lesion is considered to be a carcinoma in situ without spread beyond the dermal-epidermal junction. Over time, as many as 10% of these lesions experience invasion. Efforts have been made to correlate arsenic and Bowen disease. The results have been inconclusive at best.

Squamous cell carcinoma from Bowen disease tends to be more aggressive than that which has degenerated from actinic keratoses, and metastases occur in as many as one third of patients. Its expression is associated with other skin and internal malignancies.

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