Materiały źródłowe

• #1 Bowen’s Disease Symptoms, Causes, Diagnosis, and Treatment

  https://www.healthline.com/health/skin-cancer/bowens-disease

  Bowens disease is an early form of squamous cell carcinoma (SCC), a type of skin cancer. […] Since Bowens disease is an SCC, its important you get medical attention right away. […] The following methods are used to diagnose Bowens disease: Medical history. This will help a doctor or healthcare professional understand what might be causing your symptoms. Physical examination. A doctor will check your lesions and surrounding skin for discoloration, scaling, and other symptoms. Biopsy. A doctor takes a sample of your lesion and examines it under a microscope. This can help them rule out other skin conditions. […] The key is to treat Bowens disease as early as possible. Thats because its more difficult to treat in its later stages. […] Bowens disease is a cancerous condition. It involves scaly patches that can turn into skin cancer over time. The most common cause is prolonged sun exposure, but HPV infections, arsenic exposure, and a compromised immune system can also play a role.

• #2 Bowen’s disease – treatment and symptoms | healthdirect

  https://www.healthdirect.gov.au/bowens-disease

  Bowen’s disease is a very early form of skin cancer. […] How is Bowen’s disease diagnosed? […] A doctor can diagnose Bowen’s disease by looking carefully at the affected patch of skin. […] Most people will need a biopsy. This is when a small sample of tissue is removed to be examined in a laboratory. The biopsy can confirm the diagnosis.

• #3 Bowen’s disease

  https://www.nhs.uk/conditions/bowens-disease/

  Bowen’s disease can eventually develop into a different type of skin cancer called squamous cell skin cancer if it’s left undiagnosed or neglected. […] It’s important to get a proper diagnosis, as Bowen’s disease can look like other conditions, such as psoriasis or eczema. […] If necessary, your GP will refer you to a skin specialist (dermatologist) to determine what the problem is. […] If they are not sure about the cause, they may need to remove a small sample of skin so it can be looked at more closely (a biopsy).

• #4 Bowen's disease

  https://www.pcds.org.uk/clinical-guidance/bowens-disease

  Bowen’s disease is an intra-epidermal (in situ) squamous cell carcinoma of the skin. The rate of transformation in to invasive squamous cell carcinoma (SCC) is approximately 3%. […] A biopsy is only needed if there is diagnostic uncertainty, although if a squamous cell carcinoma (SCC) is suspected the patient should be referred urgently to Secondary Care (two-week wait) without a biopsy. Features suggestive of transformation into an SCC include an elevated palpable component, induration, ulceration, tenderness, and surrounding inflammation. […] Bowen disease is characterised by full thickness epidermal dysplasia and disordered differentiation with loss of epithelial polarity. The intraepidermal portion of cutaneous adnexae is generally affected. Parakeratosis and acanthosis are usually present and keratinocytes show variable pleomorphism, nuclear hyperchromasia and nuclear enlargement.

• #5 Bowen’s disease – treatment and symptoms | healthdirect

  https://www.healthdirect.gov.au/bowens-disease

  Bowen’s disease is a very early form of skin cancer. […] How is Bowen’s disease diagnosed? […] A doctor can diagnose Bowen’s disease by looking carefully at the affected patch of skin. […] Most people will need a biopsy. This is when a small sample of tissue is removed to be examined in a laboratory. The biopsy can confirm the diagnosis.

• #6 Bowen’s disease | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/pre-cancerous-and-genetic-conditions/bowens-disease

  If your GP thinks you might have Bowens disease, you will be referred to a doctor who specialises in skin problems. They are called a dermatologist. They will examine your skin and may be able to diagnose it from the way it looks. They may also take a sample of skin to confirm the diagnosis. This is called a biopsy. […] Before you have a biopsy, a doctor will numb the area with a local anaesthetic. They will remove a small piece of the affected skin and examine it under a microscope. […] Ask your doctor when your results will be available and how you will get them.

• #7 Bowen’s disease | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bowens-disease

  Bowen’s disease produces persistent red scaly patches on the skin that are not sore or itchy. Bowen’s disease is easily overlooked. It is not unusual for Bowen’s disease to be diagnosed during a routine skin examination. […] Diagnosis methods include: physical examination, medical history, biopsy of the lesion, including laboratory examination of the tissue sample.

• #8 Bowen’s disease – Melbourne Skin & Dermatology Clinic

  https://dermatology.melbourne/services/bowens-disease/

  Diagnosis is generally made through a skin biopsy. […] Differential diagnosis includes eczema, psoriasis, superficial basal cell carcinoma, and actinic keratosis. […] Diagnosed via skin biopsy. […] Differential diagnosis includes several other skin conditions.

• #9 Bowen’s disease – Therapeutics in Dermatology

  https://www.therapeutique-dermatologique.org/spip.php?article1749

  Bowens disease is a relatively rare intraepithelial squamous cell carcinoma in situ. […] Its clinical diagnosis can be difficult: subungual, perianal, pigmented, verrucous Bowens disease. Histological verification is therefore required for the diagnosis of Bowens disease, used to confirm the absence of microinvasion on serial sections. […] Clinical diagnosis of Bowens disease can be difficult. The following conditions should be considered in the differential diagnosis of cutaneous Bowens disease: psoriasis, lupus erythematosus, seborrheic warts, actinic keratosis, verrucous lichen planus or superficial basal cell carcinoma. […] Serial sections should be made to ensure that there is no break in the basal layer at any of the sampling points, particularly in cases of genital Bowens disease.

• #10 Bowen’s disease (Squamous Cell Carcinoma In Situ; erythroplasia of Queyrat; Squamous Cell Carcinoma In Situ of the Penis) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/bowens-disease-squamous-cell-carcinoma-in-situ-erythroplasia-of-queyrat-squamous-cell-carcinoma-in-situ-of-the-penis/

  Patients often present with a history of a persistent red, scaly plaque that can be asymptomatic or pruritic. […] Biopsy, most commonly a shave, is used for diagnosis and to evaluate for progression to invasive SCC. […] A lesion that is nonresponsive to steroid treatment should suggest the possibility of Bowens disease and warrants a biopsy for diagnosis. […] The clinical appearance and location of the lesion should assist in making the diagnosis, but a biopsy is needed to definitively determine the diagnosis. […] Bowens disease carries a 3% to 8% risk of developing into an invasive SCC in nongenital areas. […] Erythroplasia of Queyrat has been found to be more aggressive than Bowens disease, with progression to invasive SCC in up to 33% of cases; of these cases, 20% result in metastasis. […] Mohs micrographic surgery should be considered when treating Bowens disease, as these lesions often have extensive subclinical spread.

• #11 Squamous Cell Carcinoma in Situ – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/skin-cancers/squamous-cell-carcinoma-in-situ

  Squamous cell carcinoma in situ (formerly called Bowen disease) most commonly occurs on sun-exposed areas of the skin but may occur anywhere. […] A biopsy is the standard procedure for confirming the diagnosis of squamous cell carcinoma in situ. During this procedure, doctors remove a piece of the tumor and examine it under a microscope.

• #12 Bowen’s disease

  https://www.nhs.uk/conditions/bowens-disease/

  Bowen’s disease can eventually develop into a different type of skin cancer called squamous cell skin cancer if it’s left undiagnosed or neglected. […] It’s important to get a proper diagnosis, as Bowen’s disease can look like other conditions, such as psoriasis or eczema. […] If necessary, your GP will refer you to a skin specialist (dermatologist) to determine what the problem is. […] If they are not sure about the cause, they may need to remove a small sample of skin so it can be looked at more closely (a biopsy).

• #13 Bowen’s Disease: Skin Cancer Linked to HPV Infection

  https://www.webmd.com/cancer/what-is-bowens-disease

  You cant always tell by looking at your skin if you have Bowens disease. Many other skin conditions can look the same. […] Your doctor usually has to take a sample of your skin for testing (biopsy) to confirm it.

• #14 Bowen’s Disease – Identify the Symptoms for Skin Cancer Diagnosis | Medanta

  https://www.medanta.org/patient-education-blog/could-that-odd-patch-on-your-skin-be-bowens-disease-find-out-now

  It’s not always possible to diagnose Bowen’s disease simply by looking at your skin because many different skin disorders may have similar symptoms. […] To diagnose the cancer, your doctor typically has to take a sample of your skin for cancer testing, called a skin biopsy.

• #15 Pillar | Medanta

  https://www.medanta.org/pillar/bowens-disease-symptoms-risks-prevention-stages-treatment

  Diagnosing Bowen’s Disease promptly and accurately is essential for effective management and treatment. This article delves into the diverse methods and approaches utilised in Bowen’s Disease diagnosis. […] A thorough physical examination is also performed to detect any visible skin irregularities. Bowen’s Disease often manifests as red, scaly, and slightly elevated patches on the skin, which can be mistaken for other skin conditions, such as psoriasis or eczema. A clinical assessment is crucial for pinpointing suspicious lesions and determining the necessity of further diagnostic tests. […] Dermoscopy aids healthcare professionals in recognizing specific features linked to Bowen’s Disease, such as irregular pigmentation, vascular patterns, and scaly or crusty areas. While dermoscopy is a valuable tool in the diagnostic process, it may not render a definitive diagnosis independently and is frequently employed in conjunction with other methods.

• #16 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://www.spandidos-publications.com/10.3892/ol.2019.10079

  Bowen’s disease (BD) is a relatively frequent non-melanoma skin cancer occurring mostly in elderly people. Until now, the usual way to establish the diagnosis is histopathological examination of a skin biopsy. Dermoscopy and reflectance confocal microscopy (RCM) are modern alternative methods that can be used as quick and non-invasive diagnostic techniques and as follow-up instruments in cases in which a conservative treatment is chosen for the management of BD. […] There are no very specific dermoscopic criteria for the diagnosis of this disease, but some dermoscopic features (scaly surface, vascular structures and pigmentation) can be found more frequent and can be helpful for the diagnosis. RCM of BD shows an acanthotic epidermis with two types of targetoid cells: the first, a large cell with bright center and dark peripheral halo, the second, a cell with dark center and a bright rim surrounded by a dark hallo, related with dyskeratotic cells on histological examination. BD management could be improved by using non-invasive, in vivo imaging techniques that allow a fast and easy diagnosis and can be used as follow-up tools. However, larger studies are necessary for the validation of our observations.

• #17 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://www.spandidos-publications.com/10.3892/ol.2019.10079

  There are no specific dermoscopic criteria described in the literature for the diagnosis of BD but some features such as scaly surface, vascular structures and pigmentation defined by small brown globules with patchy distribution, reticular pigmentation and homogeneous gray brownish pigmentation, can be found more frequently and although not specific, they can be helpful in making a diagnosis. […] The typical or atypical vascular component is well-represented BD and consists of regular dotted vessels, linear, bushy, arborizing, hairpin-like vessels and milky red globules. […] RCM is relatively new imaging tool applied for non-invasive evaluation of the skin, especially in dermato-oncology that provides horizontal scanning of the skin at nearly histological resolution. […] On RCM, BD shows an acanthotic epidermis with an atypical/disarranged honey-comb pattern with grainy appearance with variation in cell and nuclear morphology. Two types of targetoid cells were identified: the first, a large cell with bright center and dark peripheral halo, the second a cell with dark center and a bright rim surrounded by a dark halo.

• #18 Intraepidermal squamous cell carcinoma, intraepidermal SCC, Bowen’s disease

  https://dermnetnz.org/topics/intraepidermal-squamous-cell-carcinoma

  Intraepidermal SCC is often recognised clinically. Dermatoscopy of a red scaly irregular plaque is supportive if it reveals crops of rounded and coiled blood vessels. […] Diagnosis may be confirmed by biopsy; histology reveals full thickness dysplasia of the epidermis.

• #19 Actinic keratosis / Bowens’s disease / Squamous cell carcinoma – dermoscopedia

  https://dermoscopedia.org/04-SCC

  Bowen’s disease represents an intraepithelial carcinoma or in situ Squamous cell carcinoma (SCC). The most frequent clinical presentation is an erythematous scaly patch or slightly elevated plaque. […] The archetypal dermoscopic pattern of BD is characterized by two types of vascular patterns: Clustered vascular pattern: Focal, clustered, asymmetric distribution of the vessels; Glomerular (coiled) vessels: Tortuous capillaries, which are larger than dotted vessels and are often distributed in clusters mimicking the glomerular apparatus of the kidney. The concurrent presence of hyperkeratosis (surface scale) allows a high diagnostic probability. […] Pigmented Bowens disease (pBD) is more frequently described in darker skin phenotypes. The following dermoscopic criteria are suggested to be a specific clue for the diagnosis of pBD: Brown or grey dots: these dots are a strong clue when arranged as linear radial lines at the periphery of the lesion; Pink or skin colored eccentric structureless areas; Glomerular (coiled) vessels, arranged randomly, as clusters, or in radial lines.

• #20 Actinic keratosis / Bowens’s disease / Squamous cell carcinoma – dermoscopedia

  https://dermoscopedia.org/04-SCC

  Bowen’s disease represents an intraepithelial carcinoma or in situ Squamous cell carcinoma (SCC). The most frequent clinical presentation is an erythematous scaly patch or slightly elevated plaque. […] The archetypal dermoscopic pattern of BD is characterized by two types of vascular patterns: Clustered vascular pattern: Focal, clustered, asymmetric distribution of the vessels; Glomerular (coiled) vessels: Tortuous capillaries, which are larger than dotted vessels and are often distributed in clusters mimicking the glomerular apparatus of the kidney. The concurrent presence of hyperkeratosis (surface scale) allows a high diagnostic probability. […] Pigmented Bowens disease (pBD) is more frequently described in darker skin phenotypes. The following dermoscopic criteria are suggested to be a specific clue for the diagnosis of pBD: Brown or grey dots: these dots are a strong clue when arranged as linear radial lines at the periphery of the lesion; Pink or skin colored eccentric structureless areas; Glomerular (coiled) vessels, arranged randomly, as clusters, or in radial lines.

• #21 Actinic keratosis / Bowens’s disease / Squamous cell carcinoma – dermoscopedia

  https://dermoscopedia.org/04-SCC

  Bowen’s disease represents an intraepithelial carcinoma or in situ Squamous cell carcinoma (SCC). The most frequent clinical presentation is an erythematous scaly patch or slightly elevated plaque. […] The archetypal dermoscopic pattern of BD is characterized by two types of vascular patterns: Clustered vascular pattern: Focal, clustered, asymmetric distribution of the vessels; Glomerular (coiled) vessels: Tortuous capillaries, which are larger than dotted vessels and are often distributed in clusters mimicking the glomerular apparatus of the kidney. The concurrent presence of hyperkeratosis (surface scale) allows a high diagnostic probability. […] Pigmented Bowens disease (pBD) is more frequently described in darker skin phenotypes. The following dermoscopic criteria are suggested to be a specific clue for the diagnosis of pBD: Brown or grey dots: these dots are a strong clue when arranged as linear radial lines at the periphery of the lesion; Pink or skin colored eccentric structureless areas; Glomerular (coiled) vessels, arranged randomly, as clusters, or in radial lines.

• #22 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6444281/

  At present, the only way to establish diagnostic certainty of BD is by histopathological examination of a skin biopsy. Current trends in skin imaging are focused on non-invasive techniques characterized by rapidity, possibility to evaluate the evolution of the lesions over time by preserving skin integrity, lack of invasiveness and patient comfort. […] In BD, dermoscopy can be used as a valuable follow-up tool. […] RCM is relatively new imaging tool applied for non-invasive evaluation of the skin, especially in dermato-oncology that provides horizontal scanning of the skin at nearly histological resolution. […] In conclusion, in this study we demonstrated that BD management could be improved by using non-invasive, in vivo imaging techniques that allow a fast and easy diagnosis and to follow-up the treatment efficacy. However, larger studies are necessary for the validation of our observations.

• #23 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  Cutaneous squamous cell carcinoma (cSCC) is the second-most-prevalent malignancy in humans. A delayed diagnosis of cSCC leads to heightened invasiveness and positive surgical margins. Bowen’s disease (BD) represents an early form of cSCC and presents as a small erythematous, photo-distributed, psoriasiform plaque. […] Although certain dermoscopy features in BD are quite characteristic, histopathology remains the gold standard for diagnosis and provides a severity-scoring system that assists in guiding appropriate treatment strategies. […] The diagnoses of vulvar intraepithelial neoplasia (VIN) and PeIN present significant challenges and typically necessitate one or more biopsies, potentially guided by dermoscopy. […] Histopathology remains the gold standard for diagnosis, revealing hyperkeratosis, parakeratosis, acanthosis with elongation and thickening of rete ridges, absence of the granular layer, and full-thickness keratinocyte atypia without breaching the dermo–epidermal junction.

• #24

  https://journals.lww.com/idoj/fulltext/2022/13020/bowen_s_disease.2.aspx

  Bowen’s disease (BD) is an in-situ squamous cell carcinoma of epidermis. […] Histopathology is the gold standard diagnostic modality to confirm the diagnosis. […] Immunohistochemistry, dermoscopy, and reflectance confocal microscopy are the adjuvant modalities used in the diagnosis of BD. […] The epidermis shows hyperkeratosis and parakeratosis, marked acanthosis with elongation and thickening of rete ridges. The keratinocytes show atypia, which spans the entire epidermis, not breaching the dermo-epidermal junction. […] In BD, two types of giant cells are recognized in the epidermis. […] The histopathology of mucous membrane BD lesions are less definite than skin BD. […] In BD, the keratinocyte nuclei for proliferating cell nuclear antigen (PCNA) have a diffuse pattern of staining. […] There are no standard dermoscopic criteria mentioned in the literature for the diagnosis of BD. […] Reflectance confocal microscopy is an ancillary tool, which enables in differentiating pigmented BD from other pigmented lesions.

• #25 Bowen’s disease | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/pre-cancerous-and-genetic-conditions/bowens-disease

  If your GP thinks you might have Bowens disease, you will be referred to a doctor who specialises in skin problems. They are called a dermatologist. They will examine your skin and may be able to diagnose it from the way it looks. They may also take a sample of skin to confirm the diagnosis. This is called a biopsy. […] Before you have a biopsy, a doctor will numb the area with a local anaesthetic. They will remove a small piece of the affected skin and examine it under a microscope. […] Ask your doctor when your results will be available and how you will get them.

• #26 Basal Cell and Cutaneous Squamous Cell Carcinomas: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0915/p339.html

  Multiple biopsy techniques are available for sampling lesions suspected to be carcinomas. Initial tissue sampling is typically performed using a shave technique if the lesion is raised, or using a punch biopsy of the most abnormal-appearing skin. Complete excision may be an appropriate initial diagnostic procedure for smaller lesions. Pigmented lesions and those with any features concerning for melanoma risk should always be evaluated using a full-thickness technique. […] The Brigham and Women’s Hospital tumor classification system can determine the stage of CSCC based on tumor risk factors. The eighth edition of the American Joint Committee on Cancer staging manual adds nodal and metastasis classification, but the Brigham and Women’s Hospital system may provide superior prognostication for patients with localized CSCC. […] The National Comprehensive Cancer Network has developed a stratification framework that offers practical guidance for clinicians in distinguishing BCC and CSCC at low vs. high risk of recurrence.

• #27 Bowen Disease: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1100113-overview

  Perform a shave or punch biopsy to confirm the diagnosis of Bowen disease. Incorporating follicular structures in the biopsy material is helpful, as is sampling many areas of larger lesions to exclude evidence of invasion amounting to a cutaneous squamous cell carcinoma. […] Perform a total body skin examination on patients with Bowen disease on sun-exposed skin. Studies indicate a higher incidence of nonmelanoma skin cancers may exist in these patients.

• #28 Bowen’s Disease of the Eyelid: a Teaching Case Report | The Journal of Optometric Education

  https://journal.opted.org/article/bowens-disease-of-the-eyelid-a-teaching-case-report/

  Bowens disease (BD), also known as squamous cell carcinoma in situ, is a precancerous skin lesion confined to the epidermis. […] The intent of this case report is to describe clinical characteristics of BD, appropriate workup, treatment, management and differential diagnosis. […] A comprehensive workup is necessary to diagnose an individual with BD. The lesion is examined for its color, shape, size, border and elevation, and palpated to determine malignancy potential. Diagnosis is confirmed via biopsy or dermoscopy. […] BD biopsies are performed by shave, punch or excisional techniques. Shave biopsy is the preferred method and used for raised lesions that do not extend into the dermis. […] Diagnosis is confirmed via biopsy or dermoscopy. […] Several treatment options for BD are available and categorized into surgical and topical interventions.

• #29 Diagnosis and Treatment of Basal Cell and Squamous Cell Carcinoma | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0715/p161.html

  Initial tissue sampling for diagnosis of suspected nonmelanoma skin cancer is typically performed using a shave technique if the lesion is raised, or using a 2- to 4-mm punch biopsy of the most abnormal-appearing skin. Complete excision may be an appropriate initial diagnostic procedure for smaller tumors. Pigmented tumors or those eliciting any clinical suspicion of melanoma should always be evaluated using a full-thickness technique. Exfoliative cytology may be considered for evaluation of suspected basal cell carcinoma in patients in whom even a 2-mm punch biopsy would be inappropriate. […] Treatment of basal cell carcinoma with Mohs micrographic surgery has the lowest recurrence rate. However, because of cost and limited availability, it is best considered for larger tumors (greater than 2 cm), for more invasive histologic subtypes (micronodular, infiltrative, and morpheaform), or for tumors at sites with higher risk of recurrence. […] Bowen disease may also be treated with surgical excision, electrodesiccation and curettage, cryotherapy, or topical fluorouracil.

• #30 Squamous Cell Carcinoma: What it is, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17480-squamous-cell-carcinoma

  What is squamous cell carcinoma in situ? Squamous cell carcinoma in situ is also known as Bowen disease. The term in situ means that the cancer cells are only in the top layer of your skin (epidermis). The most common places to find Bowen disease is on sun-exposed areas of your skin, but the condition can also appear on the skin near your anal cavity and genitals, like on your labia or vulva (vulvar cancer). […] How is squamous cell carcinoma diagnosed? Your healthcare provider will physically examine the area of your body where you have symptoms, looking specifically at the size, shape and location of the lump or lesion. Your healthcare provider will also ask questions to learn more about your medical history and your symptoms, which could include: […] What tests diagnose squamous cell carcinoma? After your physical exam, your healthcare provider might offer tests to confirm a diagnosis, which could include: Skin biopsy: Removing a small sample of the affected tissue to examine it under a microscope. Imaging tests (CT scan or MRI): Your healthcare provider will use an imaging test to identify the size of your carcinoma underneath your skin and to see if it spread to other parts of your body, especially your lymph nodes.

• #31 Bowen Disease: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1100113-overview

  Perform a shave or punch biopsy to confirm the diagnosis of Bowen disease. Incorporating follicular structures in the biopsy material is helpful, as is sampling many areas of larger lesions to exclude evidence of invasion amounting to a cutaneous squamous cell carcinoma. […] Perform a total body skin examination on patients with Bowen disease on sun-exposed skin. Studies indicate a higher incidence of nonmelanoma skin cancers may exist in these patients.

• #32 Bowen disease | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/bowen-disease

  Bowen disease, also known as squamous cell carcinoma in situ, is a type of skin cancer characterized by the overproliferation of squamous cells in the epidermis. […] Diagnosis often involves a biopsy to differentiate Bowen disease from other skin cancers. […] Bowen disease can easily be mistaken for other skin cancers, such as invasive SCC and basal cell carcinoma. Therefore, a punch or shave biopsy of the lesion is essential to initiate appropriate treatment, irrespective of location. The sample must include the full thickness of the epidermis and, as much as possible, hair structures in deeper layers. […] Apart from routine skin examinations as part of a regular physical examination, there are no formal screening tests for Bowen disease.

• #33 Bowen disease | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/bowen-disease

  Bowen disease, also known as squamous cell carcinoma in situ, is a type of skin cancer characterized by the overproliferation of squamous cells in the epidermis. […] Diagnosis often involves a biopsy to differentiate Bowen disease from other skin cancers. […] Bowen disease can easily be mistaken for other skin cancers, such as invasive SCC and basal cell carcinoma. Therefore, a punch or shave biopsy of the lesion is essential to initiate appropriate treatment, irrespective of location. The sample must include the full thickness of the epidermis and, as much as possible, hair structures in deeper layers. […] Apart from routine skin examinations as part of a regular physical examination, there are no formal screening tests for Bowen disease.

• #34 Bowen Disease: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1100113-overview

  Perform a shave or punch biopsy to confirm the diagnosis of Bowen disease. Incorporating follicular structures in the biopsy material is helpful, as is sampling many areas of larger lesions to exclude evidence of invasion amounting to a cutaneous squamous cell carcinoma. […] Perform a total body skin examination on patients with Bowen disease on sun-exposed skin. Studies indicate a higher incidence of nonmelanoma skin cancers may exist in these patients.

• #35 Bowen’s disease – Therapeutics in Dermatology

  https://www.therapeutique-dermatologique.org/spip.php?article1749

  Bowens disease is a relatively rare intraepithelial squamous cell carcinoma in situ. […] Its clinical diagnosis can be difficult: subungual, perianal, pigmented, verrucous Bowens disease. Histological verification is therefore required for the diagnosis of Bowens disease, used to confirm the absence of microinvasion on serial sections. […] Clinical diagnosis of Bowens disease can be difficult. The following conditions should be considered in the differential diagnosis of cutaneous Bowens disease: psoriasis, lupus erythematosus, seborrheic warts, actinic keratosis, verrucous lichen planus or superficial basal cell carcinoma. […] Serial sections should be made to ensure that there is no break in the basal layer at any of the sampling points, particularly in cases of genital Bowens disease.

• #36 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  Cutaneous squamous cell carcinoma (cSCC) is the second-most-prevalent malignancy in humans. A delayed diagnosis of cSCC leads to heightened invasiveness and positive surgical margins. Bowen’s disease (BD) represents an early form of cSCC and presents as a small erythematous, photo-distributed, psoriasiform plaque. […] Although certain dermoscopy features in BD are quite characteristic, histopathology remains the gold standard for diagnosis and provides a severity-scoring system that assists in guiding appropriate treatment strategies. […] The diagnoses of vulvar intraepithelial neoplasia (VIN) and PeIN present significant challenges and typically necessitate one or more biopsies, potentially guided by dermoscopy. […] Histopathology remains the gold standard for diagnosis, revealing hyperkeratosis, parakeratosis, acanthosis with elongation and thickening of rete ridges, absence of the granular layer, and full-thickness keratinocyte atypia without breaching the dermo–epidermal junction.

• #37 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  Cutaneous squamous cell carcinoma (cSCC) is the second-most-prevalent malignancy in humans. A delayed diagnosis of cSCC leads to heightened invasiveness and positive surgical margins. Bowen’s disease (BD) represents an early form of cSCC and presents as a small erythematous, photo-distributed, psoriasiform plaque. […] Although certain dermoscopy features in BD are quite characteristic, histopathology remains the gold standard for diagnosis and provides a severity-scoring system that assists in guiding appropriate treatment strategies. […] The diagnoses of vulvar intraepithelial neoplasia (VIN) and PeIN present significant challenges and typically necessitate one or more biopsies, potentially guided by dermoscopy. […] Histopathology remains the gold standard for diagnosis, revealing hyperkeratosis, parakeratosis, acanthosis with elongation and thickening of rete ridges, absence of the granular layer, and full-thickness keratinocyte atypia without breaching the dermo–epidermal junction.

• #38 A case series of Bowen’s disease in a tertiary care centre in South India – IJCED

  https://www.ijced.org/html-article/22702

  Bowens disease is a rare premalignant condition with multifactorial etiology. […] Hereby we report eight patients with clinical diagnosis of Bowens disease confirmed by dermoscopy and histopathology. […] Diagnosis of Bowens disease was made in six patients while differential diagnosis of TBVC / chromoblastomycosis was considered in one patient who had lesion over left index finger and in an other patient with oculocutaneous albinism, actinic keratosis was entertained. […] Dermoscopic and histopathological examination confirmed the diagnosis of Bowens disease. […] Histopathological features of Bowens disease include hyperkeratosis, parakeratosis, acanthosis, atypical keratinocytes with intense mitotic activity, hyperchromatic large pleomorphic nuclei and accompanying loss of polarity which gives an windblown appearance to the epidermis.

• #39 Cutaneous squamous-cell carcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Cutaneous_squamous-cell_carcinoma

  When confined to the epidermis, the outermost layer of the skin, the pre-invasive or in situ form of cSCC is termed Bowen’s disease. […] Diagnosis typically relies on skin examination, and is confirmed through skin biopsy. […] Diagnosis is confirmed via skin biopsy of the tissue or tissues suspected to be affected by SCC. […] Histopathologically, the epidermis in cSCC in situ (Bowen’s disease) will show hyperkeratosis and parakeratosis. […] Bowen’s disease is essentially equivalent to and used interchangeably with cSCC in situ, when not having invaded through the basement membrane. […] In cSCC in situ (Bowen’s disease), atypical squamous cells proliferate through the whole thickness of the epidermis.

• #40

  https://journals.lww.com/idoj/fulltext/2022/13020/bowen_s_disease.2.aspx

  Bowen’s disease (BD) is an in-situ squamous cell carcinoma of epidermis. […] Histopathology is the gold standard diagnostic modality to confirm the diagnosis. […] Immunohistochemistry, dermoscopy, and reflectance confocal microscopy are the adjuvant modalities used in the diagnosis of BD. […] The epidermis shows hyperkeratosis and parakeratosis, marked acanthosis with elongation and thickening of rete ridges. The keratinocytes show atypia, which spans the entire epidermis, not breaching the dermo-epidermal junction. […] In BD, two types of giant cells are recognized in the epidermis. […] The histopathology of mucous membrane BD lesions are less definite than skin BD. […] In BD, the keratinocyte nuclei for proliferating cell nuclear antigen (PCNA) have a diffuse pattern of staining. […] There are no standard dermoscopic criteria mentioned in the literature for the diagnosis of BD. […] Reflectance confocal microscopy is an ancillary tool, which enables in differentiating pigmented BD from other pigmented lesions.

• #41 Bowen's disease

  https://www.pcds.org.uk/clinical-guidance/bowens-disease

  Bowen’s disease is an intra-epidermal (in situ) squamous cell carcinoma of the skin. The rate of transformation in to invasive squamous cell carcinoma (SCC) is approximately 3%. […] A biopsy is only needed if there is diagnostic uncertainty, although if a squamous cell carcinoma (SCC) is suspected the patient should be referred urgently to Secondary Care (two-week wait) without a biopsy. Features suggestive of transformation into an SCC include an elevated palpable component, induration, ulceration, tenderness, and surrounding inflammation. […] Bowen disease is characterised by full thickness epidermal dysplasia and disordered differentiation with loss of epithelial polarity. The intraepidermal portion of cutaneous adnexae is generally affected. Parakeratosis and acanthosis are usually present and keratinocytes show variable pleomorphism, nuclear hyperchromasia and nuclear enlargement.

• #42 A case series of Bowen’s disease in a tertiary care centre in South India – IJCED

  https://www.ijced.org/html-article/22702

  Bowens disease is a rare premalignant condition with multifactorial etiology. […] Hereby we report eight patients with clinical diagnosis of Bowens disease confirmed by dermoscopy and histopathology. […] Diagnosis of Bowens disease was made in six patients while differential diagnosis of TBVC / chromoblastomycosis was considered in one patient who had lesion over left index finger and in an other patient with oculocutaneous albinism, actinic keratosis was entertained. […] Dermoscopic and histopathological examination confirmed the diagnosis of Bowens disease. […] Histopathological features of Bowens disease include hyperkeratosis, parakeratosis, acanthosis, atypical keratinocytes with intense mitotic activity, hyperchromatic large pleomorphic nuclei and accompanying loss of polarity which gives an windblown appearance to the epidermis.

• #43 Bowen’s disease on finger: A diagnostic and therapeutic challenge – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/bowens-disease-on-finger-a-diagnostic-and-therapeutic-challenge/

  Bowen’s disease commonly presents as a solitary asymptomatic plaque involving head and neck region or lower limbs. […] A skin biopsy was performed using a 4 mm punch from the plaque which showed epidermal hyperkeratosis, irregular acanthosis with many dyskeratotic cells, mitotic figures and keratinocyte dysplasia and atypia. […] These histological features were consistent with squamous cell carcinoma in situ Bowen’s disease. […] The current literature supports our approach of surgery as there are 3 reports/series on failure of imiquimod for cutaneous Bowens. […] As of now, there are no standard guidelines on the management of digital Bowens disease probably due to relative rarity of the condition. […] The current British Academy of Dermatologists (BAD) guidelines, (2006) mention that for digital Bowens, excision may be a better option than all other modalities and that micrographic surgery may be considered for tissue sparing or for poorly defined or recurrent lesions. […] All therapeutic options have failures and recurrence rates at least in the order of 5-10%, and no treatment modality appears to be superior for all clinical situations.

• #44

  https://journals.lww.com/idoj/fulltext/2022/13020/bowen_s_disease.2.aspx

  Bowen’s disease (BD) is an in-situ squamous cell carcinoma of epidermis. […] Histopathology is the gold standard diagnostic modality to confirm the diagnosis. […] Immunohistochemistry, dermoscopy, and reflectance confocal microscopy are the adjuvant modalities used in the diagnosis of BD. […] The epidermis shows hyperkeratosis and parakeratosis, marked acanthosis with elongation and thickening of rete ridges. The keratinocytes show atypia, which spans the entire epidermis, not breaching the dermo-epidermal junction. […] In BD, two types of giant cells are recognized in the epidermis. […] The histopathology of mucous membrane BD lesions are less definite than skin BD. […] In BD, the keratinocyte nuclei for proliferating cell nuclear antigen (PCNA) have a diffuse pattern of staining. […] There are no standard dermoscopic criteria mentioned in the literature for the diagnosis of BD. […] Reflectance confocal microscopy is an ancillary tool, which enables in differentiating pigmented BD from other pigmented lesions.

• #45

  https://journals.lww.com/idoj/fulltext/2022/13020/bowen_s_disease.2.aspx

  Bowen’s disease (BD) is an in-situ squamous cell carcinoma of epidermis. […] Histopathology is the gold standard diagnostic modality to confirm the diagnosis. […] Immunohistochemistry, dermoscopy, and reflectance confocal microscopy are the adjuvant modalities used in the diagnosis of BD. […] The epidermis shows hyperkeratosis and parakeratosis, marked acanthosis with elongation and thickening of rete ridges. The keratinocytes show atypia, which spans the entire epidermis, not breaching the dermo-epidermal junction. […] In BD, two types of giant cells are recognized in the epidermis. […] The histopathology of mucous membrane BD lesions are less definite than skin BD. […] In BD, the keratinocyte nuclei for proliferating cell nuclear antigen (PCNA) have a diffuse pattern of staining. […] There are no standard dermoscopic criteria mentioned in the literature for the diagnosis of BD. […] Reflectance confocal microscopy is an ancillary tool, which enables in differentiating pigmented BD from other pigmented lesions.

• #46 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  A grading system for BD helps stratify patients based on the severity of their condition. This scoring system allows for a standardized assessment of BD severity and aids in guiding appropriate treatment strategies and follow-up care. […] The clinical, histological, and immunohistochemical profile of BD, including markers such as PCNA, CK10, CK14, p16, p53, Ki-67, and p27, provide critical insights for its diagnosis and differentiation from other skin lesions. Diagnosing VIN and PeIN poses considerable challenges and typically entails one or more biopsies, potentially guided by dermoscopy and aceto-white testing. […] The early diagnosis of BD, VIN, and PeIN is crucial due to their potential for malignant transformation and significant impact on patient outcomes. Detecting these early SCCs at an initial stage enables timely and effective treatment, reducing the risk of progression to invasive SCC. Early intervention not only improves prognosis but also minimizes the likelihood of metastasis and associated complications.

• #47 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  A grading system for BD helps stratify patients based on the severity of their condition. This scoring system allows for a standardized assessment of BD severity and aids in guiding appropriate treatment strategies and follow-up care. […] The clinical, histological, and immunohistochemical profile of BD, including markers such as PCNA, CK10, CK14, p16, p53, Ki-67, and p27, provide critical insights for its diagnosis and differentiation from other skin lesions. Diagnosing VIN and PeIN poses considerable challenges and typically entails one or more biopsies, potentially guided by dermoscopy and aceto-white testing. […] The early diagnosis of BD, VIN, and PeIN is crucial due to their potential for malignant transformation and significant impact on patient outcomes. Detecting these early SCCs at an initial stage enables timely and effective treatment, reducing the risk of progression to invasive SCC. Early intervention not only improves prognosis but also minimizes the likelihood of metastasis and associated complications.

• #48 Pillar | Medanta

  https://www.medanta.org/pillar/bowens-disease-symptoms-risks-prevention-stages-treatment

  Reflectance confocal microscopy, a specific form of confocal microscopy, has exhibited promise in diagnosing Bowen’s Disease. It employs laser light to create cellular-level skin images, enabling the detection of abnormal cell patterns and structures. RCM offers the advantage of being a non-invasive, real-time imaging technique, particularly valuable for tracking lesion changes over time. […] In certain instances, additional tests may be necessary to determine Bowen’s Disease subtypes, which can impact treatment decisions. Immunohistochemistry entails the use of specific antibodies to stain tissue samples, aiding in the identification of proteins within cells. This can help differentiate Bowen’s Disease from other skin conditions and even pinpoint specific subtypes.

• #49 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  A grading system for BD helps stratify patients based on the severity of their condition. This scoring system allows for a standardized assessment of BD severity and aids in guiding appropriate treatment strategies and follow-up care. […] The clinical, histological, and immunohistochemical profile of BD, including markers such as PCNA, CK10, CK14, p16, p53, Ki-67, and p27, provide critical insights for its diagnosis and differentiation from other skin lesions. Diagnosing VIN and PeIN poses considerable challenges and typically entails one or more biopsies, potentially guided by dermoscopy and aceto-white testing. […] The early diagnosis of BD, VIN, and PeIN is crucial due to their potential for malignant transformation and significant impact on patient outcomes. Detecting these early SCCs at an initial stage enables timely and effective treatment, reducing the risk of progression to invasive SCC. Early intervention not only improves prognosis but also minimizes the likelihood of metastasis and associated complications.

• #50

  https://journals.lww.com/idoj/fulltext/2022/13020/bowen_s_disease.2.aspx

  Bowen’s disease (BD) is an in-situ squamous cell carcinoma of epidermis. […] Histopathology is the gold standard diagnostic modality to confirm the diagnosis. […] Immunohistochemistry, dermoscopy, and reflectance confocal microscopy are the adjuvant modalities used in the diagnosis of BD. […] The epidermis shows hyperkeratosis and parakeratosis, marked acanthosis with elongation and thickening of rete ridges. The keratinocytes show atypia, which spans the entire epidermis, not breaching the dermo-epidermal junction. […] In BD, two types of giant cells are recognized in the epidermis. […] The histopathology of mucous membrane BD lesions are less definite than skin BD. […] In BD, the keratinocyte nuclei for proliferating cell nuclear antigen (PCNA) have a diffuse pattern of staining. […] There are no standard dermoscopic criteria mentioned in the literature for the diagnosis of BD. […] Reflectance confocal microscopy is an ancillary tool, which enables in differentiating pigmented BD from other pigmented lesions.

• #51 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  A grading system for BD helps stratify patients based on the severity of their condition. This scoring system allows for a standardized assessment of BD severity and aids in guiding appropriate treatment strategies and follow-up care. […] The clinical, histological, and immunohistochemical profile of BD, including markers such as PCNA, CK10, CK14, p16, p53, Ki-67, and p27, provide critical insights for its diagnosis and differentiation from other skin lesions. Diagnosing VIN and PeIN poses considerable challenges and typically entails one or more biopsies, potentially guided by dermoscopy and aceto-white testing. […] The early diagnosis of BD, VIN, and PeIN is crucial due to their potential for malignant transformation and significant impact on patient outcomes. Detecting these early SCCs at an initial stage enables timely and effective treatment, reducing the risk of progression to invasive SCC. Early intervention not only improves prognosis but also minimizes the likelihood of metastasis and associated complications.

• #52 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  A grading system for BD helps stratify patients based on the severity of their condition. This scoring system allows for a standardized assessment of BD severity and aids in guiding appropriate treatment strategies and follow-up care. […] The clinical, histological, and immunohistochemical profile of BD, including markers such as PCNA, CK10, CK14, p16, p53, Ki-67, and p27, provide critical insights for its diagnosis and differentiation from other skin lesions. Diagnosing VIN and PeIN poses considerable challenges and typically entails one or more biopsies, potentially guided by dermoscopy and aceto-white testing. […] The early diagnosis of BD, VIN, and PeIN is crucial due to their potential for malignant transformation and significant impact on patient outcomes. Detecting these early SCCs at an initial stage enables timely and effective treatment, reducing the risk of progression to invasive SCC. Early intervention not only improves prognosis but also minimizes the likelihood of metastasis and associated complications.

• #53 Bowen’s disease of the nipple: a case report – Torabi – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6910/html

  Squamous cell carcinoma in situ (SCCIS), also known as Bowens disease, commonly develops in skin on areas exposed to sunlight, such as head and neck, trunk, and the extremities. […] Following complete work-up a definitive diagnosis of SCCIS was confirmed by punch biopsy. […] One should be cautious not to confuse this with other intraepithelial lesions requiring a very different approach to therapy, such as the use of topical antibacterial, antifungal, or steroidal agents. […] In conclusion, we stress the importance of differentiating this disease from Pagets disease which may have a very similar appearance, but requires a more extensive investigation for associated parenchymal disease. […] Furthermore, Bowens disease can be managed with wide nipple excision to completely remove the lesion with uninvolved margins.

• #54 Bowen’s disease of the nipple: a case report – Torabi – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6910/html

  Upon diagnosis surgical excision with clear margins should be performed. […] Histopathological features consistent with Bowens disease include abnormal mitoses of the epidermis, presence of dyskeratosis, and proliferation of atypical cells that do not exhibit evidence of dermal invasion. […] This differentiation is usually achieved by immunohistochemical staining. […] This finding is crucial in confirming the diagnosis and was consistent with the staining results obtained in the index patient. […] Multiple treatment modalities have been proposed, including surgical and non-surgical options. […] This has led to the adoption of wide local excision as the gold standard of treatment, hence the rationale for the treatment choice for this patient. […] In conclusion, we report a rare case of Bowens disease of the nipple managed successfully by wide local excision.

• #55 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6444281/

  Bowen’s disease (BD) is a relatively frequent non-melanoma skin cancer occurring mostly in elderly people. Until now, the usual way to establish the diagnosis is histopathological examination of a skin biopsy. Dermoscopy and reflectance confocal microscopy (RCM) are modern alternative methods that can be used as quick and non-invasive diagnostic techniques and as follow-up instruments in cases in which a conservative treatment is chosen for the management of BD. […] There are no very specific dermoscopic criteria for the diagnosis of this disease, but some dermoscopic features (scaly surface, vascular structures and pigmentation) can be found more frequent and can be helpful for the diagnosis. RCM of BD shows an acanthotic epidermis with two types of targetoid cells: the first, a large cell with bright center and dark peripheral halo, the second, a cell with dark center and a bright rim surrounded by a dark hallo, related with dyskeratotic cells on histological examination. BD management could be improved by using non-invasive, in vivo imaging techniques that allow a fast and easy diagnosis and can be used as follow-up tools. However, larger studies are necessary for the validation of our observations.

• #56 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6444281/

  At present, the only way to establish diagnostic certainty of BD is by histopathological examination of a skin biopsy. Current trends in skin imaging are focused on non-invasive techniques characterized by rapidity, possibility to evaluate the evolution of the lesions over time by preserving skin integrity, lack of invasiveness and patient comfort. […] In BD, dermoscopy can be used as a valuable follow-up tool. […] RCM is relatively new imaging tool applied for non-invasive evaluation of the skin, especially in dermato-oncology that provides horizontal scanning of the skin at nearly histological resolution. […] In conclusion, in this study we demonstrated that BD management could be improved by using non-invasive, in vivo imaging techniques that allow a fast and easy diagnosis and to follow-up the treatment efficacy. However, larger studies are necessary for the validation of our observations.

• #57 Pillar | Medanta

  https://www.medanta.org/pillar/bowens-disease-symptoms-risks-prevention-stages-treatment

  A skin biopsy represents the most dependable means of definitively diagnosing Bowen’s Disease. During a biopsy, a dermatologist removes a small sample of the suspicious skin lesion for subsequent laboratory analysis. To confirm cancerous cell presence, a pathologist examines the sample under a microscope. Multiple skin biopsy types exist, such as shave, punch, and excisional biopsies. Biopsy choice hinges on lesion size and location. Biopsy not only verifies the diagnosis but also offers vital information concerning the disease’s extent. […] Confocal microscopy is an advanced imaging technique facilitating real-time, high-resolution scrutiny of the skin at a cellular level. It proves especially beneficial in cases where traditional biopsies might be impractical or when a non-invasive approach is preferred. Confocal microscopy aids in visualising the cellular and structural alterations in the skin, aiding in Bowen’s Disease diagnosis.

• #58 Pillar | Medanta

  https://www.medanta.org/pillar/bowens-disease-symptoms-risks-prevention-stages-treatment

  Reflectance confocal microscopy, a specific form of confocal microscopy, has exhibited promise in diagnosing Bowen’s Disease. It employs laser light to create cellular-level skin images, enabling the detection of abnormal cell patterns and structures. RCM offers the advantage of being a non-invasive, real-time imaging technique, particularly valuable for tracking lesion changes over time. […] In certain instances, additional tests may be necessary to determine Bowen’s Disease subtypes, which can impact treatment decisions. Immunohistochemistry entails the use of specific antibodies to stain tissue samples, aiding in the identification of proteins within cells. This can help differentiate Bowen’s Disease from other skin conditions and even pinpoint specific subtypes.

• #59 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://www.spandidos-publications.com/10.3892/ol.2019.10079

  There are no specific dermoscopic criteria described in the literature for the diagnosis of BD but some features such as scaly surface, vascular structures and pigmentation defined by small brown globules with patchy distribution, reticular pigmentation and homogeneous gray brownish pigmentation, can be found more frequently and although not specific, they can be helpful in making a diagnosis. […] The typical or atypical vascular component is well-represented BD and consists of regular dotted vessels, linear, bushy, arborizing, hairpin-like vessels and milky red globules. […] RCM is relatively new imaging tool applied for non-invasive evaluation of the skin, especially in dermato-oncology that provides horizontal scanning of the skin at nearly histological resolution. […] On RCM, BD shows an acanthotic epidermis with an atypical/disarranged honey-comb pattern with grainy appearance with variation in cell and nuclear morphology. Two types of targetoid cells were identified: the first, a large cell with bright center and dark peripheral halo, the second a cell with dark center and a bright rim surrounded by a dark halo.

• #60 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://www.spandidos-publications.com/10.3892/ol.2019.10079

  The histopathological examination of BD shows characteristic features: proliferation of atypical keratinocytes with marked nucleocytoplasmic pleomorphism (poikilocarynosis), frequent atypical mitoses and dyskeratosis. There is a correlation between the histological features and the ones observed on RCM. […] In conclusion, in this study we demonstrated that BD management could be improved by using non-invasive, in vivo imaging techniques that allow a fast and easy diagnosis and to follow-up the treatment efficacy. However, larger studies are necessary for the validation of our observations.

• #61 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://www.spandidos-publications.com/10.3892/ol.2019.10079

  There are no specific dermoscopic criteria described in the literature for the diagnosis of BD but some features such as scaly surface, vascular structures and pigmentation defined by small brown globules with patchy distribution, reticular pigmentation and homogeneous gray brownish pigmentation, can be found more frequently and although not specific, they can be helpful in making a diagnosis. […] The typical or atypical vascular component is well-represented BD and consists of regular dotted vessels, linear, bushy, arborizing, hairpin-like vessels and milky red globules. […] RCM is relatively new imaging tool applied for non-invasive evaluation of the skin, especially in dermato-oncology that provides horizontal scanning of the skin at nearly histological resolution. […] On RCM, BD shows an acanthotic epidermis with an atypical/disarranged honey-comb pattern with grainy appearance with variation in cell and nuclear morphology. Two types of targetoid cells were identified: the first, a large cell with bright center and dark peripheral halo, the second a cell with dark center and a bright rim surrounded by a dark halo.

• #62 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://www.spandidos-publications.com/10.3892/ol.2019.10079

  There are no specific dermoscopic criteria described in the literature for the diagnosis of BD but some features such as scaly surface, vascular structures and pigmentation defined by small brown globules with patchy distribution, reticular pigmentation and homogeneous gray brownish pigmentation, can be found more frequently and although not specific, they can be helpful in making a diagnosis. […] The typical or atypical vascular component is well-represented BD and consists of regular dotted vessels, linear, bushy, arborizing, hairpin-like vessels and milky red globules. […] RCM is relatively new imaging tool applied for non-invasive evaluation of the skin, especially in dermato-oncology that provides horizontal scanning of the skin at nearly histological resolution. […] On RCM, BD shows an acanthotic epidermis with an atypical/disarranged honey-comb pattern with grainy appearance with variation in cell and nuclear morphology. Two types of targetoid cells were identified: the first, a large cell with bright center and dark peripheral halo, the second a cell with dark center and a bright rim surrounded by a dark halo.

• #63 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://www.spandidos-publications.com/10.3892/ol.2019.10079

  There are no specific dermoscopic criteria described in the literature for the diagnosis of BD but some features such as scaly surface, vascular structures and pigmentation defined by small brown globules with patchy distribution, reticular pigmentation and homogeneous gray brownish pigmentation, can be found more frequently and although not specific, they can be helpful in making a diagnosis. […] The typical or atypical vascular component is well-represented BD and consists of regular dotted vessels, linear, bushy, arborizing, hairpin-like vessels and milky red globules. […] RCM is relatively new imaging tool applied for non-invasive evaluation of the skin, especially in dermato-oncology that provides horizontal scanning of the skin at nearly histological resolution. […] On RCM, BD shows an acanthotic epidermis with an atypical/disarranged honey-comb pattern with grainy appearance with variation in cell and nuclear morphology. Two types of targetoid cells were identified: the first, a large cell with bright center and dark peripheral halo, the second a cell with dark center and a bright rim surrounded by a dark halo.

• #64 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://www.spandidos-publications.com/10.3892/ol.2019.10079

  At present, the only way to establish diagnostic certainty of BD is by histopathological examination of a skin biopsy. Current trends in skin imaging are focused on non-invasive techniques characterized by rapidity, possibility to evaluate the evolution of the lesions over time by preserving skin integrity, lack of invasiveness and patient comfort. […] Given that, until now, very little information related to non-invasive diagnostic techniques for BD can be found in literature. […] In 2012, Ulrich et al examined ten cases of BD using dermoscopy and RCM achieving results that match our observations. In all cases they identified parakeratosis, neutrophilic inflammatory infiltrate within the stratum corneum, atypical honeycomb pattern in the spinous layer extending to the whole epidermis thickness, two types of targetoid cells and dilated, tortuous capillaries. These observations had a good correlation with histopathological examination.

• #65

  https://journals.lww.com/idoj/fulltext/2022/13020/bowen_s_disease.2.aspx

  Bowen’s disease (BD) is an in-situ squamous cell carcinoma of epidermis. […] Histopathology is the gold standard diagnostic modality to confirm the diagnosis. […] Immunohistochemistry, dermoscopy, and reflectance confocal microscopy are the adjuvant modalities used in the diagnosis of BD. […] The epidermis shows hyperkeratosis and parakeratosis, marked acanthosis with elongation and thickening of rete ridges. The keratinocytes show atypia, which spans the entire epidermis, not breaching the dermo-epidermal junction. […] In BD, two types of giant cells are recognized in the epidermis. […] The histopathology of mucous membrane BD lesions are less definite than skin BD. […] In BD, the keratinocyte nuclei for proliferating cell nuclear antigen (PCNA) have a diffuse pattern of staining. […] There are no standard dermoscopic criteria mentioned in the literature for the diagnosis of BD. […] Reflectance confocal microscopy is an ancillary tool, which enables in differentiating pigmented BD from other pigmented lesions.

• #66 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6444281/

  At present, the only way to establish diagnostic certainty of BD is by histopathological examination of a skin biopsy. Current trends in skin imaging are focused on non-invasive techniques characterized by rapidity, possibility to evaluate the evolution of the lesions over time by preserving skin integrity, lack of invasiveness and patient comfort. […] In BD, dermoscopy can be used as a valuable follow-up tool. […] RCM is relatively new imaging tool applied for non-invasive evaluation of the skin, especially in dermato-oncology that provides horizontal scanning of the skin at nearly histological resolution. […] In conclusion, in this study we demonstrated that BD management could be improved by using non-invasive, in vivo imaging techniques that allow a fast and easy diagnosis and to follow-up the treatment efficacy. However, larger studies are necessary for the validation of our observations.

• #67 Bowen’s disease – Melbourne Skin & Dermatology Clinic

  https://dermatology.melbourne/services/bowens-disease/

  Diagnosis is generally made through a skin biopsy. […] Differential diagnosis includes eczema, psoriasis, superficial basal cell carcinoma, and actinic keratosis. […] Diagnosed via skin biopsy. […] Differential diagnosis includes several other skin conditions.

• #68 Bowen’s disease: squamous cell carcinoma in situ – PubMed

  https://pubmed.ncbi.nlm.nih.gov/1927845/

  Bowen’s disease is a premalignant condition that clinically presents as an asymptomatic, scaly or crusted plaque on the skin. Since the morphology of the lesions can mimic that of other cutaneous disorders, Bowen’s disease is often not recognized initially. The diagnosis of Bowen’s disease should be considered and a skin biopsy performed when a patient presents with a persistent cutaneous lesion that is of uncertain diagnosis or that has been previously diagnosed as „atypical” or „steroid-nonresponsive” dermatitis. […] Bowen’s Disease / diagnosis* […] Carcinoma in Situ / diagnosis* […] Carcinoma, Squamous Cell / diagnosis* […] Precancerous Conditions / diagnosis* […] Skin Neoplasms / diagnosis*

• #69 Squamous cell carcinoma in situ (Bowen disease) – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/bowens-disease-squamous-cell-carcinoma-in-situ/

  What are the aims of this leaflet? […] This leaflet has been written to help you understand more about squamous cell carcinoma in situ (Bowen disease). […] How will squamous cell carcinoma in situ be diagnosed? […] A patch of squamous cell carcinoma in situ can look rather like other scaly skin conditions, such as psoriasis. For this reason, it is often examined under a dermatoscope (a magnifying tool used to examine the skin). Sometimes a biopsy (a small sample of skin) may be taken to make the diagnosis.

• #70 Bowen’s disease – Therapeutics in Dermatology

  https://www.therapeutique-dermatologique.org/spip.php?article1749

  Bowens disease is a relatively rare intraepithelial squamous cell carcinoma in situ. […] Its clinical diagnosis can be difficult: subungual, perianal, pigmented, verrucous Bowens disease. Histological verification is therefore required for the diagnosis of Bowens disease, used to confirm the absence of microinvasion on serial sections. […] Clinical diagnosis of Bowens disease can be difficult. The following conditions should be considered in the differential diagnosis of cutaneous Bowens disease: psoriasis, lupus erythematosus, seborrheic warts, actinic keratosis, verrucous lichen planus or superficial basal cell carcinoma. […] Serial sections should be made to ensure that there is no break in the basal layer at any of the sampling points, particularly in cases of genital Bowens disease.

• #71 Differential diagnosis – Examine pictures of BCC, Bowen’s disease, actinic keratosis and psoriasis | GPonline

  https://www.gponline.com/differential-diagnosis-examine-pictures-bcc-bowens-disease-actinic-keratosis-psoriasis/dermatology/dermatology/article/1190506

  More than one lesion may be present in a similar area. […] If the diagnosis is unsure, a punch biopsy can be useful. […] Untreated, 2-3% may progress to squamous cell carcinoma (SCC). […] The diagnosis is usually clinical, unless SCC is suspected, when a punch biopsy can be useful.

• #72 Bowen’s disease – Therapeutics in Dermatology

  https://www.therapeutique-dermatologique.org/spip.php?article1749

  Bowens disease is a relatively rare intraepithelial squamous cell carcinoma in situ. […] Its clinical diagnosis can be difficult: subungual, perianal, pigmented, verrucous Bowens disease. Histological verification is therefore required for the diagnosis of Bowens disease, used to confirm the absence of microinvasion on serial sections. […] Clinical diagnosis of Bowens disease can be difficult. The following conditions should be considered in the differential diagnosis of cutaneous Bowens disease: psoriasis, lupus erythematosus, seborrheic warts, actinic keratosis, verrucous lichen planus or superficial basal cell carcinoma. […] Serial sections should be made to ensure that there is no break in the basal layer at any of the sampling points, particularly in cases of genital Bowens disease.

• #73 Bowen’s disease – Therapeutics in Dermatology

  https://www.therapeutique-dermatologique.org/spip.php?article1749

  Bowens disease is a relatively rare intraepithelial squamous cell carcinoma in situ. […] Its clinical diagnosis can be difficult: subungual, perianal, pigmented, verrucous Bowens disease. Histological verification is therefore required for the diagnosis of Bowens disease, used to confirm the absence of microinvasion on serial sections. […] Clinical diagnosis of Bowens disease can be difficult. The following conditions should be considered in the differential diagnosis of cutaneous Bowens disease: psoriasis, lupus erythematosus, seborrheic warts, actinic keratosis, verrucous lichen planus or superficial basal cell carcinoma. […] Serial sections should be made to ensure that there is no break in the basal layer at any of the sampling points, particularly in cases of genital Bowens disease.

• #74 Bowen’s disease – Therapeutics in Dermatology

  https://www.therapeutique-dermatologique.org/spip.php?article1749

  Bowens disease is a relatively rare intraepithelial squamous cell carcinoma in situ. […] Its clinical diagnosis can be difficult: subungual, perianal, pigmented, verrucous Bowens disease. Histological verification is therefore required for the diagnosis of Bowens disease, used to confirm the absence of microinvasion on serial sections. […] Clinical diagnosis of Bowens disease can be difficult. The following conditions should be considered in the differential diagnosis of cutaneous Bowens disease: psoriasis, lupus erythematosus, seborrheic warts, actinic keratosis, verrucous lichen planus or superficial basal cell carcinoma. […] Serial sections should be made to ensure that there is no break in the basal layer at any of the sampling points, particularly in cases of genital Bowens disease.

• #75 Bowen’s disease – Primary Care Notebook

  https://primarycarenotebook.com/pages/dermatology/bowens-disease

  Bowen’s disease is an intra-epidermal squamous cell carcinoma of the skin – full thickness of the epidermis is dysplastic with atypical keratinocytes, but these have not yet breached the basement membrane to become a squamous cell carcinoma: […] a provisional diagnosis can be made on clinical grounds – however definitive diagnosis requires histological examination, and this is especially important if there are atypical features, if the lesion is thicker or larger than usual (suggesting that malignant change might already have occurred), or if it does not respond to treatment as expected […] samples for histology may be obtained by excision, by punch biopsies, or by an incisional biopsy (from the clinically thickest area if the morphology of the lesion varies, in order to exclude invasive carcinoma) […] note that since other skin malignancies may co-exist with Bowen’s disease and therefore the rest of the skin, especially sun-exposed areas, should also be examined.

• #76 Spot Check | Bowen’s disease (squamous cell carcinoma in situ)

  https://www.spotcheck.clinic/conditions/skin-cancers/bowens/

  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. […] Regular check-ups will help detect new skin cancers. […] 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.

• #77 Bowen’s Disease: Causes, Symptoms, and Treatment

  https://patient.info/doctor/bowens-disease-pro

  Bowen’s disease is often diagnosed clinically, possibly with the additional use of a dermatoscope. If there is any doubt, a punch biopsy is required for histological diagnosis. […] There is no definitive treatment for Bowen’s disease; all therapeutic options have failure and recurrence rates in the order of 5-10%. […] The age of the patient and the number, size and location of the lesion(s) will all influence the choice of treatment. […] Bowen’s disease should be seen as a risk marker for other non-melanoma skin cancer (NMSC); a third of patients will have another NMSC at the time of diagnosis and patients with Bowen’s disease are 4.3 times more likely to develop NMSC in the future, most likely due to the common aetiology of ultraviolet (UV) light.

• #78 Bowen’s Disease: Causes, Symptoms, and Treatment

  https://patient.info/doctor/bowens-disease-pro

  Bowen’s disease is often diagnosed clinically, possibly with the additional use of a dermatoscope. If there is any doubt, a punch biopsy is required for histological diagnosis. […] There is no definitive treatment for Bowen’s disease; all therapeutic options have failure and recurrence rates in the order of 5-10%. […] The age of the patient and the number, size and location of the lesion(s) will all influence the choice of treatment. […] Bowen’s disease should be seen as a risk marker for other non-melanoma skin cancer (NMSC); a third of patients will have another NMSC at the time of diagnosis and patients with Bowen’s disease are 4.3 times more likely to develop NMSC in the future, most likely due to the common aetiology of ultraviolet (UV) light.

• #79 Bowen's disease

  https://www.pcds.org.uk/clinical-guidance/bowens-disease

  Patients should be followed up at three months. The presence of any remaining rough scale would suggest that the lesion has not fully responded to treatment and that more is required, whereas the presence of smooth skin, sometimes with associated post-inflammatory hyperpigmentation (especially on the lower legs), suggests that the lesion has responded well, in which case further follow-up is not required.

• #80 Spot Check | Bowen’s disease (squamous cell carcinoma in situ)

  https://www.spotcheck.clinic/conditions/skin-cancers/bowens/

  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. […] Regular check-ups will help detect new skin cancers. […] 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.

• #81 Bowen's disease

  https://www.pcds.org.uk/clinical-guidance/bowens-disease

  Patients should be followed up at three months. The presence of any remaining rough scale would suggest that the lesion has not fully responded to treatment and that more is required, whereas the presence of smooth skin, sometimes with associated post-inflammatory hyperpigmentation (especially on the lower legs), suggests that the lesion has responded well, in which case further follow-up is not required.

• #82 Bowen's disease

  https://www.pcds.org.uk/clinical-guidance/bowens-disease

  Patients should be followed up at three months. The presence of any remaining rough scale would suggest that the lesion has not fully responded to treatment and that more is required, whereas the presence of smooth skin, sometimes with associated post-inflammatory hyperpigmentation (especially on the lower legs), suggests that the lesion has responded well, in which case further follow-up is not required.

• #83 Spot Check | Bowen’s disease (squamous cell carcinoma in situ)

  https://www.spotcheck.clinic/conditions/skin-cancers/bowens/

  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. […] Regular check-ups will help detect new skin cancers. […] 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.

• #84 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  A grading system for BD helps stratify patients based on the severity of their condition. This scoring system allows for a standardized assessment of BD severity and aids in guiding appropriate treatment strategies and follow-up care. […] The clinical, histological, and immunohistochemical profile of BD, including markers such as PCNA, CK10, CK14, p16, p53, Ki-67, and p27, provide critical insights for its diagnosis and differentiation from other skin lesions. Diagnosing VIN and PeIN poses considerable challenges and typically entails one or more biopsies, potentially guided by dermoscopy and aceto-white testing. […] The early diagnosis of BD, VIN, and PeIN is crucial due to their potential for malignant transformation and significant impact on patient outcomes. Detecting these early SCCs at an initial stage enables timely and effective treatment, reducing the risk of progression to invasive SCC. Early intervention not only improves prognosis but also minimizes the likelihood of metastasis and associated complications.

• #85 Bowen’s Disease Symptoms, Causes, Diagnosis, and Treatment

  https://www.healthline.com/health/skin-cancer/bowens-disease

  Bowens disease is an early form of squamous cell carcinoma (SCC), a type of skin cancer. […] Since Bowens disease is an SCC, its important you get medical attention right away. […] The following methods are used to diagnose Bowens disease: Medical history. This will help a doctor or healthcare professional understand what might be causing your symptoms. Physical examination. A doctor will check your lesions and surrounding skin for discoloration, scaling, and other symptoms. Biopsy. A doctor takes a sample of your lesion and examines it under a microscope. This can help them rule out other skin conditions. […] The key is to treat Bowens disease as early as possible. Thats because its more difficult to treat in its later stages. […] Bowens disease is a cancerous condition. It involves scaly patches that can turn into skin cancer over time. The most common cause is prolonged sun exposure, but HPV infections, arsenic exposure, and a compromised immune system can also play a role.

• #86 Bowen’s disease (Squamous Cell Carcinoma In Situ; erythroplasia of Queyrat; Squamous Cell Carcinoma In Situ of the Penis) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/bowens-disease-squamous-cell-carcinoma-in-situ-erythroplasia-of-queyrat-squamous-cell-carcinoma-in-situ-of-the-penis/

  Patients often present with a history of a persistent red, scaly plaque that can be asymptomatic or pruritic. […] Biopsy, most commonly a shave, is used for diagnosis and to evaluate for progression to invasive SCC. […] A lesion that is nonresponsive to steroid treatment should suggest the possibility of Bowens disease and warrants a biopsy for diagnosis. […] The clinical appearance and location of the lesion should assist in making the diagnosis, but a biopsy is needed to definitively determine the diagnosis. […] Bowens disease carries a 3% to 8% risk of developing into an invasive SCC in nongenital areas. […] Erythroplasia of Queyrat has been found to be more aggressive than Bowens disease, with progression to invasive SCC in up to 33% of cases; of these cases, 20% result in metastasis. […] Mohs micrographic surgery should be considered when treating Bowens disease, as these lesions often have extensive subclinical spread.

• #87 What is Bowen’s Disease? | Advanced Dermatology

  https://www.advdermatology.com/blog/bowens-disease/

  Bowens disease, also known as squamous cell carcinoma in situ (SCC in situ), is a form of skin cancer. […] Because of this, a biopsy must usually be done to confirm the diagnosis. […] The simplest and most common treatment for SCC in situ is surgical excision. […] If you have had an SCC in situ, you have a higher risk of other skin cancers. 5% of SCC in situ will eventually develop into invasive squamous cell carcinoma if not treated.

• #88 Understanding Bowen’s Disease: A Comprehensive Guide from Southface Skin Clinic – Dorset, Bournemouth, Christchurch

  https://www.southfaceskin.com/understanding-bowens-disease-a-comprehensive-guide-from-southface-skin-clinic/

  If you notice any persistent, unusual patches on your skin, it is essential to seek medical advice. A dermatologist will perform a thorough examination and may take a biopsy of the affected skin to confirm the diagnosis. A biopsy involves removing a small sample of skin tissue for microscopic analysis. […] Bowens disease, while serious, is treatable, especially when detected early.

• #89 Practice Nursing – Managing Bowen’s disease in primary care settings

  https://www.practicenursing.com/content/clinical/managing-bowens-disease-in-primary-care-settings/

  Bowen’s disease is a rare condition, considered a precursor to squamous cell carcinoma. Because of its similarity to several other skin conditions, accurate diagnosis can be challenging. […] Bowen’s disease is a rare condition thought to affect approximately 15 per 100,000 people in the UK each year. Because of the similarity with other skin conditions, diagnosis can be challenging for clinicians. […] This article aims to give an overview of the condition and will discuss risk factors, recognition, diagnosis, treatment, and complications. It is hoped that the information provided will give nurses and non-medical prescribers more confidence in recognising this disease with the aim of getting patients an earlier diagnosis, reducing the risk of complications, and improving quality of life.

• #90 Bowen’s disease – Primary Care Notebook

  https://primarycarenotebook.com/pages/dermatology/bowens-disease

  Bowen’s disease is an intra-epidermal squamous cell carcinoma of the skin – full thickness of the epidermis is dysplastic with atypical keratinocytes, but these have not yet breached the basement membrane to become a squamous cell carcinoma: […] a provisional diagnosis can be made on clinical grounds – however definitive diagnosis requires histological examination, and this is especially important if there are atypical features, if the lesion is thicker or larger than usual (suggesting that malignant change might already have occurred), or if it does not respond to treatment as expected […] samples for histology may be obtained by excision, by punch biopsies, or by an incisional biopsy (from the clinically thickest area if the morphology of the lesion varies, in order to exclude invasive carcinoma) […] note that since other skin malignancies may co-exist with Bowen’s disease and therefore the rest of the skin, especially sun-exposed areas, should also be examined.

• #91 Bowen’s Disease Symptoms, Causes, Diagnosis, and Treatment

  https://www.healthline.com/health/skin-cancer/bowens-disease

  Its possible to treat Bowens disease. Your abnormal skin cells can be destroyed using treatments such as surgical removal, radiotherapy, topical chemotherapy, and cryosurgery. […] When treated early, Bowens disease has a high recovery rate. The best way to lower your risk is to avoid or limit excess sun exposure.

• #92 Bowen’s Disease: Causes, Symptoms, and Treatment

  https://patient.info/doctor/bowens-disease-pro

  Bowen’s disease is often diagnosed clinically, possibly with the additional use of a dermatoscope. If there is any doubt, a punch biopsy is required for histological diagnosis. […] There is no definitive treatment for Bowen’s disease; all therapeutic options have failure and recurrence rates in the order of 5-10%. […] The age of the patient and the number, size and location of the lesion(s) will all influence the choice of treatment. […] Bowen’s disease should be seen as a risk marker for other non-melanoma skin cancer (NMSC); a third of patients will have another NMSC at the time of diagnosis and patients with Bowen’s disease are 4.3 times more likely to develop NMSC in the future, most likely due to the common aetiology of ultraviolet (UV) light.

• #93 Bowen’s disease on finger: A diagnostic and therapeutic challenge – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/bowens-disease-on-finger-a-diagnostic-and-therapeutic-challenge/

  Bowen’s disease commonly presents as a solitary asymptomatic plaque involving head and neck region or lower limbs. […] A skin biopsy was performed using a 4 mm punch from the plaque which showed epidermal hyperkeratosis, irregular acanthosis with many dyskeratotic cells, mitotic figures and keratinocyte dysplasia and atypia. […] These histological features were consistent with squamous cell carcinoma in situ Bowen’s disease. […] The current literature supports our approach of surgery as there are 3 reports/series on failure of imiquimod for cutaneous Bowens. […] As of now, there are no standard guidelines on the management of digital Bowens disease probably due to relative rarity of the condition. […] The current British Academy of Dermatologists (BAD) guidelines, (2006) mention that for digital Bowens, excision may be a better option than all other modalities and that micrographic surgery may be considered for tissue sparing or for poorly defined or recurrent lesions. […] All therapeutic options have failures and recurrence rates at least in the order of 5-10%, and no treatment modality appears to be superior for all clinical situations.

• #94 Bowen Disease – Toronto Dermatology Centre

  https://torontodermatologycentre.com/bowen-disease/

  Bowens disease most commonly presents as a slow growing, persistent red scaly patch on areas of skin chronically exposed to the sun. […] The diagnosis is made clinically by a physician and sometimes confirmed by a biopsy. […] A small percentage of cases will recur after treatment and so ongoing surveillance is advised, as well as continued sun protection and avoidance measures.

• #95 Bowen’s disease | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/pre-cancerous-and-genetic-conditions/bowens-disease

  If your GP thinks you might have Bowens disease, you will be referred to a doctor who specialises in skin problems. They are called a dermatologist. They will examine your skin and may be able to diagnose it from the way it looks. They may also take a sample of skin to confirm the diagnosis. This is called a biopsy. […] Before you have a biopsy, a doctor will numb the area with a local anaesthetic. They will remove a small piece of the affected skin and examine it under a microscope. […] Ask your doctor when your results will be available and how you will get them.

• #96 Bowen’s disease | nidirect

  https://www.nidirect.gov.uk/conditions/bowens-disease

  Bowen’s disease is a very early form of skin cancer that’s easily treatable. […] It’s important to get a proper diagnosis. […] See your GP if you have a persistent red, scaly patch of skin and don’t know the cause. […] If necessary, your GP will refer you to a skin specialist (dermatologist) to work out what the problem is. […] If they’re not sure about the cause, they may need to remove a small sample of skin so it can be looked at more closely (a biopsy). […] It’s important to get a proper diagnosis, as Bowen’s disease can look like other conditions, such as psoriasis or eczema.

• #97 Bowen’s disease | nidirect

  https://www.nidirect.gov.uk/conditions/bowens-disease

  Bowen’s disease is a very early form of skin cancer that’s easily treatable. […] It’s important to get a proper diagnosis. […] See your GP if you have a persistent red, scaly patch of skin and don’t know the cause. […] If necessary, your GP will refer you to a skin specialist (dermatologist) to work out what the problem is. […] If they’re not sure about the cause, they may need to remove a small sample of skin so it can be looked at more closely (a biopsy). […] It’s important to get a proper diagnosis, as Bowen’s disease can look like other conditions, such as psoriasis or eczema.

• #98 Bowen’s disease: squamous cell carcinoma in situ – PubMed

  https://pubmed.ncbi.nlm.nih.gov/1927845/

  Bowen’s disease is a premalignant condition that clinically presents as an asymptomatic, scaly or crusted plaque on the skin. Since the morphology of the lesions can mimic that of other cutaneous disorders, Bowen’s disease is often not recognized initially. The diagnosis of Bowen’s disease should be considered and a skin biopsy performed when a patient presents with a persistent cutaneous lesion that is of uncertain diagnosis or that has been previously diagnosed as „atypical” or „steroid-nonresponsive” dermatitis. […] Bowen’s Disease / diagnosis* […] Carcinoma in Situ / diagnosis* […] Carcinoma, Squamous Cell / diagnosis* […] Precancerous Conditions / diagnosis* […] Skin Neoplasms / diagnosis*

• #99 Squamous Cell Carcinoma in Situ – Dermatologic Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/dermatologic-disorders/cancers-of-the-skin/squamous-cell-carcinoma-in-situ

  Diagnosis is by biopsy. […] Diagnosis is by biopsy, which shows full-thickness epidermal dysplasia but no dermal involvement. […] Squamous cell carcinoma in situ is often suspected when a rash secondary to a disorder such as psoriasis or atopic dermatitis fails to respond to treatment.

• #100 Bowen's disease

  https://www.pcds.org.uk/clinical-guidance/bowens-disease

  Bowen’s disease is an intra-epidermal (in situ) squamous cell carcinoma of the skin. The rate of transformation in to invasive squamous cell carcinoma (SCC) is approximately 3%. […] A biopsy is only needed if there is diagnostic uncertainty, although if a squamous cell carcinoma (SCC) is suspected the patient should be referred urgently to Secondary Care (two-week wait) without a biopsy. Features suggestive of transformation into an SCC include an elevated palpable component, induration, ulceration, tenderness, and surrounding inflammation. […] Bowen disease is characterised by full thickness epidermal dysplasia and disordered differentiation with loss of epithelial polarity. The intraepidermal portion of cutaneous adnexae is generally affected. Parakeratosis and acanthosis are usually present and keratinocytes show variable pleomorphism, nuclear hyperchromasia and nuclear enlargement.

• #101 Bowen's disease

  https://www.pcds.org.uk/clinical-guidance/bowens-disease

  Bowen’s disease is an intra-epidermal (in situ) squamous cell carcinoma of the skin. The rate of transformation in to invasive squamous cell carcinoma (SCC) is approximately 3%. […] A biopsy is only needed if there is diagnostic uncertainty, although if a squamous cell carcinoma (SCC) is suspected the patient should be referred urgently to Secondary Care (two-week wait) without a biopsy. Features suggestive of transformation into an SCC include an elevated palpable component, induration, ulceration, tenderness, and surrounding inflammation. […] Bowen disease is characterised by full thickness epidermal dysplasia and disordered differentiation with loss of epithelial polarity. The intraepidermal portion of cutaneous adnexae is generally affected. Parakeratosis and acanthosis are usually present and keratinocytes show variable pleomorphism, nuclear hyperchromasia and nuclear enlargement.

• #102 What is Bowen’s Disease? Causes, Symptoms, and Treatment Methods | DocHospitals

  https://dochospitals.com/en/bowens-disease-atc2610/

  To diagnose Bowen’s disease, a thorough physical examination is performed initially. The characteristics of the lesion are carefully evaluated. In most cases, a biopsy is necessary to confirm the diagnosis definitively.

• #103 Understanding Bowen’s Disease – Dorset, Bournemouth, Christchurch

  https://www.southfaceskin.com/understanding-bowens-disease/

  Diagnosing Bowens disease typically involves a thorough examination of the affected skin and may require a skin biopsy to confirm the presence of abnormal cells. […] Once diagnosed, treatment options may include: […] In conclusion, Bowens disease is a precancerous skin condition that requires prompt diagnosis and treatment by a qualified dermatologist. If you notice any unusual changes in your skin, such as red, scaly patches that do not heal, its essential to schedule a consultation with a dermatologist for a comprehensive evaluation.

• #104 Bowen’s Disease | Gainesville Dermatology & Skin Surgery

  https://www.gainesvilledermatologyskinsurgery.com/bowens-disease/

  Bowen’s disease is generally suspected by its characteristic appearance on the skin, such as the presence of typically Bowen’s disease lesions. […] During your appointment, your dermatologist will examine your skin and may be able to diagnose this skin condition based on its appearance alone. […] They may also take a sample of your skin to confirm their diagnosis. […] This sample is known as a biopsy. […] Once the area is sufficiently numbed, the dermatologist will remove a small piece of the affected area of skin and then examine it under a microscope.

• #105 Squamous Cell Carcinoma In Situ—The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat

  https://www.mdpi.com/2075-4418/14/16/1799

  Cutaneous squamous cell carcinoma (cSCC) is the second-most-prevalent malignancy in humans. A delayed diagnosis of cSCC leads to heightened invasiveness and positive surgical margins. Bowen’s disease (BD) represents an early form of cSCC and presents as a small erythematous, photo-distributed, psoriasiform plaque. […] Although certain dermoscopy features in BD are quite characteristic, histopathology remains the gold standard for diagnosis and provides a severity-scoring system that assists in guiding appropriate treatment strategies. […] The diagnoses of vulvar intraepithelial neoplasia (VIN) and PeIN present significant challenges and typically necessitate one or more biopsies, potentially guided by dermoscopy. […] Histopathology remains the gold standard for diagnosis, revealing hyperkeratosis, parakeratosis, acanthosis with elongation and thickening of rete ridges, absence of the granular layer, and full-thickness keratinocyte atypia without breaching the dermo–epidermal junction.

• #106 Non-invasive imaging techniques for the in vivo diagnosis of Bowen’s disease: Three case reports

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6444281/

  Bowen’s disease (BD) is a relatively frequent non-melanoma skin cancer occurring mostly in elderly people. Until now, the usual way to establish the diagnosis is histopathological examination of a skin biopsy. Dermoscopy and reflectance confocal microscopy (RCM) are modern alternative methods that can be used as quick and non-invasive diagnostic techniques and as follow-up instruments in cases in which a conservative treatment is chosen for the management of BD. […] There are no very specific dermoscopic criteria for the diagnosis of this disease, but some dermoscopic features (scaly surface, vascular structures and pigmentation) can be found more frequent and can be helpful for the diagnosis. RCM of BD shows an acanthotic epidermis with two types of targetoid cells: the first, a large cell with bright center and dark peripheral halo, the second, a cell with dark center and a bright rim surrounded by a dark hallo, related with dyskeratotic cells on histological examination. BD management could be improved by using non-invasive, in vivo imaging techniques that allow a fast and easy diagnosis and can be used as follow-up tools. However, larger studies are necessary for the validation of our observations.

• #107 Bowen’s disease of the nipple: a case report – Torabi – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6910/html

  Upon diagnosis surgical excision with clear margins should be performed. […] Histopathological features consistent with Bowens disease include abnormal mitoses of the epidermis, presence of dyskeratosis, and proliferation of atypical cells that do not exhibit evidence of dermal invasion. […] This differentiation is usually achieved by immunohistochemical staining. […] This finding is crucial in confirming the diagnosis and was consistent with the staining results obtained in the index patient. […] Multiple treatment modalities have been proposed, including surgical and non-surgical options. […] This has led to the adoption of wide local excision as the gold standard of treatment, hence the rationale for the treatment choice for this patient. […] In conclusion, we report a rare case of Bowens disease of the nipple managed successfully by wide local excision.

• #108 Bowen’s disease – Primary Care Notebook

  https://primarycarenotebook.com/pages/dermatology/bowens-disease

  Bowen’s disease is an intra-epidermal squamous cell carcinoma of the skin – full thickness of the epidermis is dysplastic with atypical keratinocytes, but these have not yet breached the basement membrane to become a squamous cell carcinoma: […] a provisional diagnosis can be made on clinical grounds – however definitive diagnosis requires histological examination, and this is especially important if there are atypical features, if the lesion is thicker or larger than usual (suggesting that malignant change might already have occurred), or if it does not respond to treatment as expected […] samples for histology may be obtained by excision, by punch biopsies, or by an incisional biopsy (from the clinically thickest area if the morphology of the lesion varies, in order to exclude invasive carcinoma) […] note that since other skin malignancies may co-exist with Bowen’s disease and therefore the rest of the skin, especially sun-exposed areas, should also be examined.

• #109 Understanding Bowen’s Disease: Symptoms,… | Newry Private Clinic

  https://newryprivateclinic.com/our-clinic/news/understanding-bowens-disease-symptoms-causes-and-treatments

  Bowens disease is a form of early skin cancer, also known as squamous cell carcinoma in situ. This means the cancerous cells are confined to the outer layer of the skin (the epidermis) and have not yet spread deeper. […] The condition often appears as a persistent red, scaly patch that may resemble other skin conditions, which can make diagnosis tricky without medical evaluation. […] Because Bowens disease can mimic other skin conditions, early detection is key. If caught early, treatment is usually straightforward and highly effective, significantly reducing the risk of progression to invasive cancer. […] A dermatologist typically performs a skin biopsy to confirm the diagnosis. This involves taking a small sample of the affected skin for laboratory analysis. […] Treatment depends on the lesions size and location. Options include topical creams (like imiquimod), cryotherapy, photodynamic therapy, or surgical removal. […] Yes, if not treated, Bowens disease can develop into invasive squamous cell carcinoma, which is more serious and may spread to other parts of the body.

• #110 Ep 89 – Bowen’s disease

  https://gpnotebook.com/podcasts/dermatology/ep-89-bowens-disease

  Bowen’s disease, also known as squamous cell carcinoma in situ, is a type of skin disorder characterised by the presence of precancerous or intra-epidermal squamous cell carcinoma. […] In this episode, Dr Roger Henderson looks at how best to diagnose and manage Bowens disease, as well as looking at its prognosis and prevention. […] Clinically, Bowen’s disease often presents as well-defined, scaly, reddish-brown patches or plaques on the skin. These lesions may resemble eczema or psoriasis, making diagnosis challenging without proper evaluation. […] Diagnosis is typically confirmed through a skin biopsy, although this may not always be necessary depending upon clinical appearance and the diagnostic confidence of the clinician involved.

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