Bowen's disease
Encyclopedia
Bowen's disease (also known as "squamous cell carcinoma in situ") is a neoplastic skin disease, it can be considered as an early stage or intraepidermal form of squamous cell carcinoma
Squamous cell carcinoma
Squamous cell carcinoma , occasionally rendered as "squamous-cell carcinoma", is a histologically distinct form of cancer. It arises from the uncontrolled multiplication of malignant cells deriving from epithelium, or showing particular cytological or tissue architectural characteristics of...

. It was named after Mark Bowen. Erythroplasia of Queyrat
Erythroplasia of Queyrat
Erythroplasia of Queyrat is a squamous cell carcinoma in situ of the glans penis.Like Bowen's Disease, it is associated with Human Papilloma Virus 16 and is a precursor for invasive squamous cell carcinoma.It is named for Louis Queyrat....

 is a form of squamous cell carcinoma in situ arising on the glans or prepuce, possibly induced by HPV.

Causes

Causes of BD include solar damage, arsenic
Arsenic
Arsenic is a chemical element with the symbol As, atomic number 33 and relative atomic mass 74.92. Arsenic occurs in many minerals, usually in conjunction with sulfur and metals, and also as a pure elemental crystal. It was first documented by Albertus Magnus in 1250.Arsenic is a metalloid...

, immunosuppression
Immunosuppression
Immunosuppression involves an act that reduces the activation or efficacy of the immune system. Some portions of the immune system itself have immuno-suppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse reaction to treatment of other...

 (including AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

), viral infection (human papillomavirus
Human papillomavirus
Human papillomavirus is a member of the papillomavirus family of viruses that is capable of infecting humans. Like all papillomaviruses, HPVs establish productive infections only in keratinocytes of the skin or mucous membranes...

 or HPV) and chronic skin injury and dermatoses.

Signs and symptoms

Bowen's disease typically presents as a gradually enlarging, well demarcated erythematous plaque with an irregular border and surface crusting or scaling. BD may occur at any age in adults but is rare before the age of 30 years - most patients are aged over 60. Any site may be affected, although involvement of palms or soles is uncommon. BD occurs predominantly in women (70-85% of cases). About 60-85% of patients have lesions on the lower leg, usually in previously or presently sun exposed areas of skin.

This is a persistent progressive non-elevated red scaly or crusted plaque which is due to an intraepidermal carcinoma and is potentially malignant. The lesions may occur anywhere on the skin surface or on mucosal surfaces. Freezing, cauterization or diathermy coagulation is often effective treatment.

Histology

Bowen's disease is essentially equivalent to squamous cell carcinoma in situ. Atypical squamous cells proliferate through the whole thickness of the epidermis. The entire tumor is confined to the epidermis and does not invade into the dermis. The cells in Bowen's are often highly atypical under the microscope, and may in fact look more unusual than the cells of some invasive squamous cell carcinomas.

Treatment

Photodynamic therapy
Photodynamic therapy
Photodynamic therapy is used clinically to treat a wide range of medical conditions, including malignant cancers, and is recognised as a treatment strategy which is both minimally invasive and minimally toxic...

 (PDT), Cryotherapy
Cryosurgery
Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. The term comes from the Greek words cryo and surgery meaning "hand work" or "handiwork"....

 (freezing) or local chemotherapy (with 5-fluorouracil) are favored by some clinicians over excision. Because the cells of Bowen's disease have not invaded the dermis, it has a much better prognosis than invasive squamous cell carcinoma. Outstanding results have been noted with the use of imiquimod
Imiquimod
Imiquimod is a prescription medication that acts as an immune response modifier. It is marketed by Meda AB, Graceway Pharmaceuticals and iNova Pharmaceuticals under the trade names Aldara and Zyclara, and by Mochida as Beselna. It is also referred to as R-837.- History :The original FDA approval...

for Bowen's disease of the skin, including the penis (erythroplasia of Queyrat), although Imiquimod is not FDA approved for the treatment of squamous cell carcinoma.

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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