Materiały źródłowe

• #1 Bowen's disease

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

  Bowen disease is characterised by fullthickness 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. […] A single freeze-thaw cycle with cryosurgery for 20-30 seconds – avoid in the gaiter area of the leg and other areas of poor skin healing. For larger patches treatment may be better tolerated if half of the lesion is treated initially and the other half six weeks later. […] Efudix cream (5-FU cream) OD for four weeks. Hands should be washed thoroughly after application. The treated area must be left uncovered and the cream washed off approximately 8 hours after application. Warn the patient to expect some redness, crusting and mild discomfort. After four weeks stop the treatment and consider using a mild topical steroid eg 1% Hydrocortisone or Eumovate cream BD for two weeks to help settle down any inflammation.

• #2 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  Bowens disease (squamous cell carcinoma in situ) has a 3%5% risk to develop into invasive squamous cell carcinoma. […] Multiple treatment options for Bowens disease have been described and are established with advantages and disadvantages. […] Therefore there is need for non-invasive/non-destructive but effective treatment options. […] We would like to give an overview of established therapies and more detailed information about the newer treatment options for Bowens disease with topical diclofenac, topical imiquimod and photodynamic therapy. […] The different treatment options for BD are cryotherapy, curettage with cautery, excision, 5-fluorouracil (5-FU), radiotherapy, laser, photodynamic therapy (PDT), imiquimod and some other therapies that were described in some case reports or small numbers of patients. Up to now none of the treatment options has been unequivocally proven to be superior to any other.

• #3 Bowen’s Disease Treatment Reading – Causes, Symptoms & Treatments | Derma

  https://www.dermareading.co.uk/bowens-disease

  While Bowen’s disease is not classed as non-melanoma skin cancer, and the disease itself is not usually serious, the concern is that it is a precancerous form of squamous cell carcinoma (SCC) – sometimes referred to as squamous cell carcinoma in situ. […] It’s estimated that between 1 in 20 to 1 in 30 people with untreated Bowen’s disease develop SCC, and although squamous cell skin cancer is often treatable, it can spread deeper into the body and is sometimes very serious. […] It is vital that patients worried about a lesion visit their GPs, who are often able to diagnose pre-cancerous lesions. The GP may refer the patient to a dermatologist for treatment which may include a biopsy – if they feel it is appropriate. […] Treatment of Bowens Disease at Derma […] There are a number of treatment options for Bowen’s disease, and the dermatologist will help you identify which are suitable, and which option is best for you.

• #4 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. […] There are many ways to treat Bowen’s disease. […] Because it is such an early cancer, it can usually be cured. […] The best type of treatment for you will depend on: the size and thickness of the Bowen’s disease, where it is on your body, your age, your health in general. […] You can choose what treatment to have. […] Sometimes, Bowen’s disease comes back after treatment. It is important to go to follow-up appointments with your doctor or dermatologist. […] Freezing it off (cryotherapy): Liquid nitrogen is sprayed onto the patch of skin to freeze it. It will scab over and fall off after a few days. This procedure can be a little uncomfortable. […] Chemotherapy cream: A medicine such as 5-fluorouracil or imiquimod is put on the patch. You need to use the cream regularly for a few weeks. The skin often gets red and inflamed before it gets better.

• #5 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  Bowens disease (squamous cell carcinoma in situ) has a 3%5% risk to develop into invasive squamous cell carcinoma. […] Multiple treatment options for Bowens disease have been described and are established with advantages and disadvantages. […] Therefore there is need for non-invasive/non-destructive but effective treatment options. […] We would like to give an overview of established therapies and more detailed information about the newer treatment options for Bowens disease with topical diclofenac, topical imiquimod and photodynamic therapy. […] The different treatment options for BD are cryotherapy, curettage with cautery, excision, 5-fluorouracil (5-FU), radiotherapy, laser, photodynamic therapy (PDT), imiquimod and some other therapies that were described in some case reports or small numbers of patients. Up to now none of the treatment options has been unequivocally proven to be superior to any other.

• #6 Bowen’s Disease: A Six-year Retrospective Study of Treatment with Emphasis on Resection Margins | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1771

  Bowens disease is an in situ squamous cell carcinoma of the skin with various treatment modalities available. A major advantage of surgical excision is the opportunity to histologically examine the resection margins. […] Available treatment options for BD are cryotherapy, curettage, surgical excision, photodynamic therapy (PDT), laser therapy, imiquimod 5% cream and 5-fluorouracil cream. […] The UK guidelines state that no single treatment modality is superior for all clinical situations. All therapeutic options have failure and recurrence rates in the order of 5-10%. […] The French guideline recommends surgical excision for BD with a minimal margin, but does not specify what this margin should be. […] In the Netherlands low risk SCC are excised with a 5 mm safety margin, margins for BD are not specified. […] Theoretically reducing the safety margin from 5 mm to 4 or 3 mm potentially reduces the complete excision rate from 94.4% to 87.0% and 74.1%, respectively. […] We recommend that a safety margin of 5 mm should be used in treating BD patients to reach a high complete excision rate.

• #7 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #8 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  For specific guidelines and recommendations, please see British Association of Dermatologists guidelines for the management of people with squamous cell carcinoma in situ (Bowens disease) 2022. […] Each treatment modality has advantages and disadvantages. Choosing the best therapeutic option involves an analysis of various factors such as lesional size, number, site, degree of functional impairment, modality availability, and cost. […] 5-Fluorouracil is a topical antineoplastic agent that interferes with DNA synthesis via inhibition of thymidylate synthetase and subsequently cell proliferation. […] Imiquimod 5% cream, a topical immune response modifier, applied 3-7 d/wk, appears to possibly be a successful treatment option for Bowen disease. […] Consider x-ray or grenz-ray radiation therapy for poor surgical candidates or patients with multiple lesions.

• #9 Bowen’s disease

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

  photodynamic therapy (PDT) a light-sensitive cream is applied to the affected skin and a laser is directed on to the skin a few hours later to destroy the abnormal cells. The treatment session usually lasts between 8 to 45 minutes. You may need more than 1 session. […] surgery the abnormal skin is cut out under local anaesthetic and stitches may be needed afterwards. […] In some cases, your dermatologist may just advise monitoring your skin closely for example, if it’s very slow growing and they feel the side effects of treatment will outweigh the benefits.

• #10 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  Photodynamic therapy (PDT) has also been used, with variable success, for the treatment of Bowen disease. […] This surgery is the most common and preferred treatment for smaller lesions and those not in problematic areas, such as the face and digits. […] Mohs micrographic surgery is an excellent method for larger lesions, poorly demarcated lesions, recurrent lesions on the head and neck, or areas where tissue sparing is vital, such as digital or genital lesions. […] Curettage and electrodesiccation, cryotherapy, and laser ablation are established treatment modalities for Bowen disease. […] Treatment efficacy is largely determined by the skill of the clinician. […] Cryotherapy is another common therapeutic option, especially for single and small lesions. […] Case reports and series have shown a benefit of using argon, carbon dioxide, and Nd:YAG lasers in the treatment of some Bowen disease lesions.

• #11 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  This paper is focused on the newer treatment options for BD: topical diclofenac and imiquimod and photodynamic therapy. […] In conclusion cryotherapy with liquid nitrogen is an effective, commonly used option in the treatment of BD entailing only low costs. […] In summary curettage and cautery is a safe and effective therapy of BD with a very good cost-benefit analysis. […] In conclusion surgical excision of BD is one of the standard treatments especially for small and single, digital and perianal BD. […] In summary the commercially available 5% 5-FU preparation has shown its efficacy in short- and long-term studies and can be used for the treatment of BD in good or even bad healing sites and for special sites like fingers or penis. […] In conclusion radiotherapy should not be used for poor healing sites (especially not for the lower leg) but it can be an alternative with high efficacy when other treatment options (eg, surgery) are difficult or not possible.

• #12 Bowen’s Disease: A Six-year Retrospective Study of Treatment with Emphasis on Resection Margins | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1771

  Bowens disease is an in situ squamous cell carcinoma of the skin with various treatment modalities available. A major advantage of surgical excision is the opportunity to histologically examine the resection margins. […] Available treatment options for BD are cryotherapy, curettage, surgical excision, photodynamic therapy (PDT), laser therapy, imiquimod 5% cream and 5-fluorouracil cream. […] The UK guidelines state that no single treatment modality is superior for all clinical situations. All therapeutic options have failure and recurrence rates in the order of 5-10%. […] The French guideline recommends surgical excision for BD with a minimal margin, but does not specify what this margin should be. […] In the Netherlands low risk SCC are excised with a 5 mm safety margin, margins for BD are not specified. […] Theoretically reducing the safety margin from 5 mm to 4 or 3 mm potentially reduces the complete excision rate from 94.4% to 87.0% and 74.1%, respectively. […] We recommend that a safety margin of 5 mm should be used in treating BD patients to reach a high complete excision rate.

• #13 Bowen’s Disease: A Six-year Retrospective Study of Treatment with Emphasis on Resection Margins | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1771

  Bowens disease is an in situ squamous cell carcinoma of the skin with various treatment modalities available. A major advantage of surgical excision is the opportunity to histologically examine the resection margins. […] Available treatment options for BD are cryotherapy, curettage, surgical excision, photodynamic therapy (PDT), laser therapy, imiquimod 5% cream and 5-fluorouracil cream. […] The UK guidelines state that no single treatment modality is superior for all clinical situations. All therapeutic options have failure and recurrence rates in the order of 5-10%. […] The French guideline recommends surgical excision for BD with a minimal margin, but does not specify what this margin should be. […] In the Netherlands low risk SCC are excised with a 5 mm safety margin, margins for BD are not specified. […] Theoretically reducing the safety margin from 5 mm to 4 or 3 mm potentially reduces the complete excision rate from 94.4% to 87.0% and 74.1%, respectively. […] We recommend that a safety margin of 5 mm should be used in treating BD patients to reach a high complete excision rate.

• #14 Analysis on the Effectiveness and Characteristics of Treatment Modalities for Bowen’s Disease: An Observational Study

  https://www.mdpi.com/2077-0383/11/10/2741

  In our study, 65.29% of the patients were treated with surgical excision, which showed the best efficacy of 100% and only 1 case of recurrence, in penile BD. […] Imiquimod is a topical immunomodulatory heterocyclic imidazoquinoline amide with both anti-HPV and antitumor effects and is potentially useful for HPV-associated BD as well as for non-HPV-associated BD. […] PDT is effective for non-surgical patients who have extensive or multiple lesions or for patients who have lesions on poor healing sites or on functional locations such as digital and penile lesions. […] Cryotherapy remains one of the main treatment options because of its advantages in terms of accessibility and price in cases where it is difficult to perform surgery. […] This study focused on the effectiveness of clinical treatment options for BD treatment. We demonstrated that surgical excision provides excellent management for removal of BD if it is possible. However, PDT can be also considered as an effective alternative if patient compliance is ensured.

• #15 Bowen’s Disease: A Six-year Retrospective Study of Treatment with Emphasis on Resection Margins | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1771

  Bowens disease is an in situ squamous cell carcinoma of the skin with various treatment modalities available. A major advantage of surgical excision is the opportunity to histologically examine the resection margins. […] Available treatment options for BD are cryotherapy, curettage, surgical excision, photodynamic therapy (PDT), laser therapy, imiquimod 5% cream and 5-fluorouracil cream. […] The UK guidelines state that no single treatment modality is superior for all clinical situations. All therapeutic options have failure and recurrence rates in the order of 5-10%. […] The French guideline recommends surgical excision for BD with a minimal margin, but does not specify what this margin should be. […] In the Netherlands low risk SCC are excised with a 5 mm safety margin, margins for BD are not specified. […] Theoretically reducing the safety margin from 5 mm to 4 or 3 mm potentially reduces the complete excision rate from 94.4% to 87.0% and 74.1%, respectively. […] We recommend that a safety margin of 5 mm should be used in treating BD patients to reach a high complete excision rate.

• #16 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  Photodynamic therapy (PDT) has also been used, with variable success, for the treatment of Bowen disease. […] This surgery is the most common and preferred treatment for smaller lesions and those not in problematic areas, such as the face and digits. […] Mohs micrographic surgery is an excellent method for larger lesions, poorly demarcated lesions, recurrent lesions on the head and neck, or areas where tissue sparing is vital, such as digital or genital lesions. […] Curettage and electrodesiccation, cryotherapy, and laser ablation are established treatment modalities for Bowen disease. […] Treatment efficacy is largely determined by the skill of the clinician. […] Cryotherapy is another common therapeutic option, especially for single and small lesions. […] Case reports and series have shown a benefit of using argon, carbon dioxide, and Nd:YAG lasers in the treatment of some Bowen disease lesions.

• #17 Bowen’s disease – wikidoc

  https://www.wikidoc.org/index.php/Bowen%27s_disease

  Different treatment options for Bowen’s disease include the following: Watch and wait, Cryosurgery/Freezing, Topical cream, Curettage electrodesiccation or cryotherapy, Cauterization or diathermy coagulation, Photodynamic therapy (PDT), Radiation therapy, Excision, Mohs micrographic surgery. […] Mohs micrographic surgery uses special training technique involving the skin removal, layer by layer with subsequent examination of each layer under microscope, until no abnormal cells are remaining.

• #18 Bowen’s Disease Treatment |Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/bowens-disease/

  Cryotherapy alone also has a failure rate of up to 30%. […] Curettage and cautery (electrodessication and curettage, EDC) may be preferable to cryotherapy in terms of pain, healing, and recurrence rate (up to 20% with EDC). […] Photodynamic therapy (PDT) is also successful with Bowens disease by the virtue of being able to treat large areas. […] Various radiotherapy techniques have been used to treat Bowens disease. […] Finally, Mohs surgery remains the gold standard for treatment of Bowens disease except for small trunk and extremity lesions. […] Topical and destructive therapies have the potential to partially clear the lesion creating noncontiguous skip tumors.

• #19 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/

  The response to topical imiquimod was unsatisfactory in the present case as the lesion, though responded well initially but recurred later even after two courses of thirteen and sixteen weeks, respectively. […] 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.

• #20 Bowen’s disease

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

  There are a number of treatment options for Bowen’s disease. Talk to your dermatologist about which treatment is most suitable for you. […] The main treatments are: […] cryotherapy liquid nitrogen is sprayed on to the affected skin to freeze it. The procedure may be painful and the skin may remain a bit uncomfortable for a few days. The affected skin will scab over and fall off within a few weeks. […] imiquimod cream or chemotherapy cream (such as 5-fluorouracil) this is applied to the affected skin regularly for a few weeks. It may cause your skin to become red and inflamed before it gets better. […] curettage and cautery the affected area of skin is scraped away under local anaesthetic, where the skin is numbed, and heat or electricity is used to stop any bleeding, leaving the area to scab over and heal after a few weeks.

• #21 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 the affected area is very small, it may be possible to treat Bowens disease by freezing it. This is called cryotherapy or cryosurgery. A dermatologist will carefully spray liquid nitrogen onto the area to freeze and destroy the abnormal cells. […] Curettage is when a skin specialist doctor (dermatologist) scrapes away the affected area. They then use heat or electricity to stop any bleeding. This is called electrocautery. […] Doctors may use surgery to remove areas of Bowens disease, using a local anaesthetic. Surgery may be used to remove deeper areas, or if other treatments have not been successful. […] Laser treatment uses intense light energy to remove tissue. It is sometimes used to treat Bowen’s disease that affects the fingers or genitals. […] Radiotherapy uses high-energy x-rays to treat abnormal cells. It is sometimes used if Bowens disease is causing symptoms such as pain or bleeding.

• #22 Bowen’s disease – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/bowens-disease/

  Several treatments are available for Bowen disease: […] Freezing the area with liquid nitrogen (cryotherapy). This is carried out in the clinic. It can sometimes be painful, and can cause redness, puffiness, blistering or crusting, and may be slow to heal. It can be done in stages for large patches. However, it is less suitable for patches on the lower legs, or other sites where there is poor healing. […] This involves scraping off the abnormal skin under a local anaesthetic. The area then heals with a scab, like a graze. […] This is a cream that may control or completely remove SCC in situ. There are different ways of using it, and your doctor will explain to you how to best use it. It works by killing the abnormal skin cells. This means that the skin will become red and look worse during treatment, but this is temporary. After completing the course of treatment, the skin reaction should settle down over time. If the reaction was severe, then there is a risk of skin discolouration or scarring.

• #23 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  This paper is focused on the newer treatment options for BD: topical diclofenac and imiquimod and photodynamic therapy. […] In conclusion cryotherapy with liquid nitrogen is an effective, commonly used option in the treatment of BD entailing only low costs. […] In summary curettage and cautery is a safe and effective therapy of BD with a very good cost-benefit analysis. […] In conclusion surgical excision of BD is one of the standard treatments especially for small and single, digital and perianal BD. […] In summary the commercially available 5% 5-FU preparation has shown its efficacy in short- and long-term studies and can be used for the treatment of BD in good or even bad healing sites and for special sites like fingers or penis. […] In conclusion radiotherapy should not be used for poor healing sites (especially not for the lower leg) but it can be an alternative with high efficacy when other treatment options (eg, surgery) are difficult or not possible.

• #24 Bowen’s Disease Treatment |Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/bowens-disease/

  Cryotherapy alone also has a failure rate of up to 30%. […] Curettage and cautery (electrodessication and curettage, EDC) may be preferable to cryotherapy in terms of pain, healing, and recurrence rate (up to 20% with EDC). […] Photodynamic therapy (PDT) is also successful with Bowens disease by the virtue of being able to treat large areas. […] Various radiotherapy techniques have been used to treat Bowens disease. […] Finally, Mohs surgery remains the gold standard for treatment of Bowens disease except for small trunk and extremity lesions. […] Topical and destructive therapies have the potential to partially clear the lesion creating noncontiguous skip tumors.

• #25 Bowen’s disease

  https://www.pcds.org.uk/patient-info-leaflets/bowens-disease

  Curettage the most commonly used surgical treatment for Bowens disease during which the lesion is scooped out, the bleeding stopped, and the wound left to heal itself without stitches. […] Excision in which the Bowens and a small margin of surrounding normal skin is cut out and stitched back together. […] No treatment watch and wait. Sometimes the healthcare professional along with the patient and/or carer may decide to leave the Bowens alone if they believe that the patient is very unlikely to come to any harm. […] It is important that you discuss treatment options with your specialist (or GP) and ask about anything that you do not understand.

• #26 Pillar | Medanta

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

  Freezing the affected skin using liquid nitrogen destroys the abnormal cells. This procedure is simple and fast, though it may cause temporary discomfort and skin discoloration. […] Abnormal skin layers are scraped off with a curette, followed by the application of an electric current to eliminate any remaining abnormal cells. This method suits small Bowen’s disease lesions. […] This treatment involves applying a photosensitizing agent to the affected skin and exposing it to specific light wavelengths, resulting in the destruction of abnormal cells. PDT is often used for larger or multiple lesions. […] In certain cases, surgical removal of the affected skin is necessary, especially for large, invasive, or cosmetically sensitive lesions. This procedure ensures complete removal and may require sutures for wound closure.

• #27 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  For specific guidelines and recommendations, please see British Association of Dermatologists guidelines for the management of people with squamous cell carcinoma in situ (Bowens disease) 2022. […] Each treatment modality has advantages and disadvantages. Choosing the best therapeutic option involves an analysis of various factors such as lesional size, number, site, degree of functional impairment, modality availability, and cost. […] 5-Fluorouracil is a topical antineoplastic agent that interferes with DNA synthesis via inhibition of thymidylate synthetase and subsequently cell proliferation. […] Imiquimod 5% cream, a topical immune response modifier, applied 3-7 d/wk, appears to possibly be a successful treatment option for Bowen disease. […] Consider x-ray or grenz-ray radiation therapy for poor surgical candidates or patients with multiple lesions.

• #28 Bowen’s disease

  https://www.pcds.org.uk/patient-info-leaflets/bowens-disease

  It is important to ask a healthcare professional for a full skin examination to check for other skin lesions that may also need attention. […] In terms of treatment, this depends on various factors including size site (where the Bowens disease is located), and your general health. […] Treatment options include: […] Efudix cream (5-FU cream) applied thinly once a day to the affected area and up to 4 mm of normal surrounding skin, usually for 4 weeks; occasionally your doctor may recommend longer. […] Cryosurgery this is the same cold spray (liquid nitrogen) used to treat warts. […] Photodynamic therapy this involves the combination of a cream with a special light source. […] Skin surgery given the usual good response to non-surgical treatments, the main indications for surgery are if the diagnosis is uncertain and/or the lesion is not responding to treatment.

• #29 Bowen’s Disease Treatment |Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/bowens-disease/

  Contact SCARS Center of Orange Country for Bowens disease treatment. […] Most therapeutic options for Bowens disease, except Mohs excision, have failure and recurrence rate of 10%-20%, and no treatment modality is best in all clinical scenarios. […] 5-fluorouracil (5-FU) is usually applied once or twice daily as a 5% cream for up to 2 months and can be repeated if needed. […] The median clearance rate with 5-FU among the studies is 80-90% with 10-20% recurrence rate. […] Imiquimod (Aldara) has the unique role as both an anti-tumor agent and an anti-viral agent given its immunomodulating action. […] Imiquimod applied daily for 16 weeks produced a cure rate between 73% and 93% in several studies. […] An innovative approach obtained 100% cure rate utilizing cryoimmunotherapy in a single study.

• #30 Non-surgical management of actinic keratosis, Bowen’s disease and non-melanoma skin cancer | The PMFA Journal

  https://www.thepmfajournal.com/features/post/non-surgical-management-of-actinic-keratosis-bowen-s-disease-and-non-melanoma-skin-cancer

  Cryotherapy is usually used in treatment of AK, BD, superficial BCC (sBCC) and sometimes, small, nBCC. […] Diclofenac in hyaluran gel (SolarazeTM) is often used in the community to treat AK and is generally accepted to be well tolerated by patients, with the main side-effect being mild skin irritation. […] 5-fluorouracil (5-FU) is a pyrimidine antimetabolite that inhibits DNA synthesis and is commonly used as a topical chemotherapeutic agent in the treatment of AK and BD. […] Imiquimod (AldaraTM) is a topical immune response modifier, and stimulates both the innate and adaptive cell-mediated immune pathways, via toll-like receptors expressed on Langerhans cells to produce anti-tumour effect. […] Ingenol mebutate (PicatoTM) is derived from the plant Euphorbia peplus, also known as milkweed. It is currently licensed in the UK as a treatment for AK.

• #31 Bowen’s disease – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/bowens-disease/

  Several treatments are available for Bowen disease: […] Freezing the area with liquid nitrogen (cryotherapy). This is carried out in the clinic. It can sometimes be painful, and can cause redness, puffiness, blistering or crusting, and may be slow to heal. It can be done in stages for large patches. However, it is less suitable for patches on the lower legs, or other sites where there is poor healing. […] This involves scraping off the abnormal skin under a local anaesthetic. The area then heals with a scab, like a graze. […] This is a cream that may control or completely remove SCC in situ. There are different ways of using it, and your doctor will explain to you how to best use it. It works by killing the abnormal skin cells. This means that the skin will become red and look worse during treatment, but this is temporary. After completing the course of treatment, the skin reaction should settle down over time. If the reaction was severe, then there is a risk of skin discolouration or scarring.

• #32 Bowen’s Disease Treatment |Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/bowens-disease/

  Contact SCARS Center of Orange Country for Bowens disease treatment. […] Most therapeutic options for Bowens disease, except Mohs excision, have failure and recurrence rate of 10%-20%, and no treatment modality is best in all clinical scenarios. […] 5-fluorouracil (5-FU) is usually applied once or twice daily as a 5% cream for up to 2 months and can be repeated if needed. […] The median clearance rate with 5-FU among the studies is 80-90% with 10-20% recurrence rate. […] Imiquimod (Aldara) has the unique role as both an anti-tumor agent and an anti-viral agent given its immunomodulating action. […] Imiquimod applied daily for 16 weeks produced a cure rate between 73% and 93% in several studies. […] An innovative approach obtained 100% cure rate utilizing cryoimmunotherapy in a single study.

• #33 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  This paper is focused on the newer treatment options for BD: topical diclofenac and imiquimod and photodynamic therapy. […] In conclusion cryotherapy with liquid nitrogen is an effective, commonly used option in the treatment of BD entailing only low costs. […] In summary curettage and cautery is a safe and effective therapy of BD with a very good cost-benefit analysis. […] In conclusion surgical excision of BD is one of the standard treatments especially for small and single, digital and perianal BD. […] In summary the commercially available 5% 5-FU preparation has shown its efficacy in short- and long-term studies and can be used for the treatment of BD in good or even bad healing sites and for special sites like fingers or penis. […] In conclusion radiotherapy should not be used for poor healing sites (especially not for the lower leg) but it can be an alternative with high efficacy when other treatment options (eg, surgery) are difficult or not possible.

• #34 Bowen’s disease – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/bowens-disease/

  This cream was originally developed for the treatment of genital warts but has been found useful in treating SCC in situ. It also causes inflammation of the skin during treatment. […] Depending on the size and location of the lesion, the abnormal skin may be cut out under local anaesthetic. This involves cutting around the lesion and, in most cases, the skin will then be stitched, and this may leave a scar. If this method of treatment is chosen, you will be informed about the type of surgery planned and any potential complications. […] A cream is applied to the skin which makes the cells in the patch of SCC in situ sensitive to particular wavelengths of light. Light from a specially designed lamp is then shone onto the patch. This treatment can be painful and cause inflammation; however, any inflammation should settle down within a few days. […] Radiotherapy and laser are other therapies occasionally used for the treatment of SCC in situ. Lasers are not available in every hospital and radiotherapy is usually reserved for people whose condition has reoccurred or who do not benefit from other treatment.

• #35 Lee Clinic Dermatology Cork | Bowens Disease

  https://www.leeclinicdermatology.ie/m/dermatology-cork/common-skin-conditions/bowens-disease

  Imiquimod (Aldara) cream. This was originally developed for the treatment of genital warts, but imiquimod cream has been found useful in treating Bowens disease. It also causes inflammation of the skin during treatment. […] Photodynamic therapy. A chemical is applied to the skin that makes the cells in the patch of Bowens disease sensitive to particular wavelengths of light. Light from a special lamp is then shone onto the lesion. This treatment can be painful and cause inflammation; however any inflammation should disappear within a few days. […] A particular problem with Bowens disease is that it is frequently found on the lower leg – where the skin is often tight and sometimes quite fragile, especially in older patients. Healing there is slow. Many factors, therefore, play a part in selecting the right treatment: […] If the affected area is judged to be thin and not likely to cause problems soon, your dermatologist may simply suggest that it is kept under observation in a clinic, or in some cases by yourself or by your GP.

• #36 Bowen’s Disease Treatment |Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/bowens-disease/

  Contact SCARS Center of Orange Country for Bowens disease treatment. […] Most therapeutic options for Bowens disease, except Mohs excision, have failure and recurrence rate of 10%-20%, and no treatment modality is best in all clinical scenarios. […] 5-fluorouracil (5-FU) is usually applied once or twice daily as a 5% cream for up to 2 months and can be repeated if needed. […] The median clearance rate with 5-FU among the studies is 80-90% with 10-20% recurrence rate. […] Imiquimod (Aldara) has the unique role as both an anti-tumor agent and an anti-viral agent given its immunomodulating action. […] Imiquimod applied daily for 16 weeks produced a cure rate between 73% and 93% in several studies. […] An innovative approach obtained 100% cure rate utilizing cryoimmunotherapy in a single study.

• #37 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  For specific guidelines and recommendations, please see British Association of Dermatologists guidelines for the management of people with squamous cell carcinoma in situ (Bowens disease) 2022. […] Each treatment modality has advantages and disadvantages. Choosing the best therapeutic option involves an analysis of various factors such as lesional size, number, site, degree of functional impairment, modality availability, and cost. […] 5-Fluorouracil is a topical antineoplastic agent that interferes with DNA synthesis via inhibition of thymidylate synthetase and subsequently cell proliferation. […] Imiquimod 5% cream, a topical immune response modifier, applied 3-7 d/wk, appears to possibly be a successful treatment option for Bowen disease. […] Consider x-ray or grenz-ray radiation therapy for poor surgical candidates or patients with multiple lesions.

• #38 Bowen’s Disease Treatment |Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/bowens-disease/

  Contact SCARS Center of Orange Country for Bowens disease treatment. […] Most therapeutic options for Bowens disease, except Mohs excision, have failure and recurrence rate of 10%-20%, and no treatment modality is best in all clinical scenarios. […] 5-fluorouracil (5-FU) is usually applied once or twice daily as a 5% cream for up to 2 months and can be repeated if needed. […] The median clearance rate with 5-FU among the studies is 80-90% with 10-20% recurrence rate. […] Imiquimod (Aldara) has the unique role as both an anti-tumor agent and an anti-viral agent given its immunomodulating action. […] Imiquimod applied daily for 16 weeks produced a cure rate between 73% and 93% in several studies. […] An innovative approach obtained 100% cure rate utilizing cryoimmunotherapy in a single study.

• #39

  https://journals.lww.com/transplantjournal/fulltext/2004/03150/treatment_of_bowen_s_disease_with_imiquimod_5_.30.aspx

  The topical application of the immunomodulator imiquimod 5% cream is highly effective in the treatment of BD, with a response rate of 93% in immunocompetent patients. […] In TR, imiquimod has only been applied in combination with 5-fluorouracil cream for the treatment of BD, but so far has never been used as a single-agent therapy. […] Our results demonstrate a high efficacy and a good tolerability of topical treatment of imiquimod 5% cream in BD in TR, which represents a promising new therapeutic modality for BD, especially on exposed areas such as the face and ears.

• #40 Analysis on the Effectiveness and Characteristics of Treatment Modalities for Bowen’s Disease: An Observational Study

  https://www.mdpi.com/2077-0383/11/10/2741

  In our study, 65.29% of the patients were treated with surgical excision, which showed the best efficacy of 100% and only 1 case of recurrence, in penile BD. […] Imiquimod is a topical immunomodulatory heterocyclic imidazoquinoline amide with both anti-HPV and antitumor effects and is potentially useful for HPV-associated BD as well as for non-HPV-associated BD. […] PDT is effective for non-surgical patients who have extensive or multiple lesions or for patients who have lesions on poor healing sites or on functional locations such as digital and penile lesions. […] Cryotherapy remains one of the main treatment options because of its advantages in terms of accessibility and price in cases where it is difficult to perform surgery. […] This study focused on the effectiveness of clinical treatment options for BD treatment. We demonstrated that surgical excision provides excellent management for removal of BD if it is possible. However, PDT can be also considered as an effective alternative if patient compliance is ensured.

• #41 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #42 Bowen’s disease – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/bowens-disease/

  This cream was originally developed for the treatment of genital warts but has been found useful in treating SCC in situ. It also causes inflammation of the skin during treatment. […] Depending on the size and location of the lesion, the abnormal skin may be cut out under local anaesthetic. This involves cutting around the lesion and, in most cases, the skin will then be stitched, and this may leave a scar. If this method of treatment is chosen, you will be informed about the type of surgery planned and any potential complications. […] A cream is applied to the skin which makes the cells in the patch of SCC in situ sensitive to particular wavelengths of light. Light from a specially designed lamp is then shone onto the patch. This treatment can be painful and cause inflammation; however, any inflammation should settle down within a few days. […] Radiotherapy and laser are other therapies occasionally used for the treatment of SCC in situ. Lasers are not available in every hospital and radiotherapy is usually reserved for people whose condition has reoccurred or who do not benefit from other treatment.

• #43 Bowen’s disease

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

  photodynamic therapy (PDT) a light-sensitive cream is applied to the affected skin and a laser is directed on to the skin a few hours later to destroy the abnormal cells. The treatment session usually lasts between 8 to 45 minutes. You may need more than 1 session. […] surgery the abnormal skin is cut out under local anaesthetic and stitches may be needed afterwards. […] In some cases, your dermatologist may just advise monitoring your skin closely for example, if it’s very slow growing and they feel the side effects of treatment will outweigh the benefits.

• #44 Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

  https://www.mdpi.com/2227-9059/12/4/795

  Photodynamic therapy is a first-line option for the treatment of Bowen’s disease. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Treatment options for Bowen’s disease are multiple, including surgical excision, cryotherapy, laser ablation, curettage with cautery, radiation therapy, topical 5% 5-fluorouracil (5-FU), imiquimod, and conventional photodynamic therapy (PDT). Current European guidelines recommend MAL-PDT for the treatment of Bowen’s disease with a strength of recommendation A and quality of evidence 1. PDT is particularly indicated for lesions at sites of poor healing, for large or multiple lesions, and in cases where surgery would be difficult or invasive such as facial, digital, nail bed, and penile lesions. The protocol involves two MAL-PDT sessions 7 days apart, repeated at 3 months, if necessary. The first large pan European study on MAL-PDT included 225 patients with histologically confirmed Bowen’s disease, randomized to MAL-PDT, cryotherapy, or topical 5% 5-FU for 4 weeks. After 3 months, lesion response rates were similar with all regimens (93% MAL-PDT, 86% cryotherapy, 83% 5-FU). Overall, the clinical response rate for MAL-PDT in the treatment of Bowen’s disease varies from 88–100% after one or two cycles at 3 months, with 68–89% of lesions clear over follow-up periods of 17–50 months. PDT has been combined with an ablative fractional resurfacing laser, CO2 laser, electrodessication, surgery, radiation, imiquimod, plum-blossom needle, and simple shaving for Bowen’s disease treatment. Combination therapy with laser-assisted techniques has been consistently demonstrated to effectively increase the penetration depth of the photosensitizer as well as increase PDT’s therapeutic effect. PDT is a safe and effective, well-established treatment option for Bowen’s disease, especially in difficult locations, large or multiple lesions, and elderly patients. The cosmetic outcome of MAL-PDT compares favorably with cryotherapy and 5% 5-FU with high levels of patient satisfaction. Patients with Bowen’s disease treated with PDT should be monitored after treatment because of the risk of incomplete response and recurrence, as well as progression to invasive cSCC, particularly for immunocompromised patients.

• #45 Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

  https://www.mdpi.com/2227-9059/12/4/795

  Photodynamic therapy is a first-line option for the treatment of Bowen’s disease. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Treatment options for Bowen’s disease are multiple, including surgical excision, cryotherapy, laser ablation, curettage with cautery, radiation therapy, topical 5% 5-fluorouracil (5-FU), imiquimod, and conventional photodynamic therapy (PDT). Current European guidelines recommend MAL-PDT for the treatment of Bowen’s disease with a strength of recommendation A and quality of evidence 1. PDT is particularly indicated for lesions at sites of poor healing, for large or multiple lesions, and in cases where surgery would be difficult or invasive such as facial, digital, nail bed, and penile lesions. The protocol involves two MAL-PDT sessions 7 days apart, repeated at 3 months, if necessary. The first large pan European study on MAL-PDT included 225 patients with histologically confirmed Bowen’s disease, randomized to MAL-PDT, cryotherapy, or topical 5% 5-FU for 4 weeks. After 3 months, lesion response rates were similar with all regimens (93% MAL-PDT, 86% cryotherapy, 83% 5-FU). Overall, the clinical response rate for MAL-PDT in the treatment of Bowen’s disease varies from 88–100% after one or two cycles at 3 months, with 68–89% of lesions clear over follow-up periods of 17–50 months. PDT has been combined with an ablative fractional resurfacing laser, CO2 laser, electrodessication, surgery, radiation, imiquimod, plum-blossom needle, and simple shaving for Bowen’s disease treatment. Combination therapy with laser-assisted techniques has been consistently demonstrated to effectively increase the penetration depth of the photosensitizer as well as increase PDT’s therapeutic effect. PDT is a safe and effective, well-established treatment option for Bowen’s disease, especially in difficult locations, large or multiple lesions, and elderly patients. The cosmetic outcome of MAL-PDT compares favorably with cryotherapy and 5% 5-FU with high levels of patient satisfaction. Patients with Bowen’s disease treated with PDT should be monitored after treatment because of the risk of incomplete response and recurrence, as well as progression to invasive cSCC, particularly for immunocompromised patients.

• #46 Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

  https://www.mdpi.com/2227-9059/12/4/795

  Photodynamic therapy is a first-line option for the treatment of Bowen’s disease. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Treatment options for Bowen’s disease are multiple, including surgical excision, cryotherapy, laser ablation, curettage with cautery, radiation therapy, topical 5% 5-fluorouracil (5-FU), imiquimod, and conventional photodynamic therapy (PDT). Current European guidelines recommend MAL-PDT for the treatment of Bowen’s disease with a strength of recommendation A and quality of evidence 1. PDT is particularly indicated for lesions at sites of poor healing, for large or multiple lesions, and in cases where surgery would be difficult or invasive such as facial, digital, nail bed, and penile lesions. The protocol involves two MAL-PDT sessions 7 days apart, repeated at 3 months, if necessary. The first large pan European study on MAL-PDT included 225 patients with histologically confirmed Bowen’s disease, randomized to MAL-PDT, cryotherapy, or topical 5% 5-FU for 4 weeks. After 3 months, lesion response rates were similar with all regimens (93% MAL-PDT, 86% cryotherapy, 83% 5-FU). Overall, the clinical response rate for MAL-PDT in the treatment of Bowen’s disease varies from 88–100% after one or two cycles at 3 months, with 68–89% of lesions clear over follow-up periods of 17–50 months. PDT has been combined with an ablative fractional resurfacing laser, CO2 laser, electrodessication, surgery, radiation, imiquimod, plum-blossom needle, and simple shaving for Bowen’s disease treatment. Combination therapy with laser-assisted techniques has been consistently demonstrated to effectively increase the penetration depth of the photosensitizer as well as increase PDT’s therapeutic effect. PDT is a safe and effective, well-established treatment option for Bowen’s disease, especially in difficult locations, large or multiple lesions, and elderly patients. The cosmetic outcome of MAL-PDT compares favorably with cryotherapy and 5% 5-FU with high levels of patient satisfaction. Patients with Bowen’s disease treated with PDT should be monitored after treatment because of the risk of incomplete response and recurrence, as well as progression to invasive cSCC, particularly for immunocompromised patients.

• #47 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #48 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #49 Treatment of Bowen Disease With Photodynamic Therapy and the Advantages of Sequential Topical Imiquimod | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-treatment-bowen-disease-with-photodynamic-articulo-S1578219016303419

  Photodynamic therapy (PDT) has been shown to be useful and effective in the treatment of actinic keratosis, Bowen disease, and basal cell carcinoma. […] PDT in monotherapy or combined sequentially with imiquimod is an excellent and well-tolerated therapeutic option for Bowen disease. The treatment has few adverse effects and shows satisfactory results, particularly in multiple large lesions in areas of difficult surgical reconstruction or in elderly patients with a high surgical risk. […] Several treatment options exist, including surgery, electrocoagulation, cryotherapy, 5-fluorouacil, 5% imiquimod, laser therapy, radiation therapy, and photodynamic therapy (PDT). […] PDT is approved for the treatment of actinic keratosis, superficial and nodular basal cell carcinoma (BCC), and BD. It is a simple technique, suitable for outpatient use, and has proven to be both useful and effective in BD.

• #50 Bowen’s disease

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

  There are a number of treatment options for Bowen’s disease. Talk to your dermatologist about which treatment is most suitable for you. […] The main treatments are: […] cryotherapy liquid nitrogen is sprayed on to the affected skin to freeze it. The procedure may be painful and the skin may remain a bit uncomfortable for a few days. The affected skin will scab over and fall off within a few weeks. […] imiquimod cream or chemotherapy cream (such as 5-fluorouracil) this is applied to the affected skin regularly for a few weeks. It may cause your skin to become red and inflamed before it gets better. […] curettage and cautery the affected area of skin is scraped away under local anaesthetic, where the skin is numbed, and heat or electricity is used to stop any bleeding, leaving the area to scab over and heal after a few weeks.

• #51 Bowen’s disease

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

  There are a number of treatment options for Bowen’s disease. Talk to your dermatologist about which treatment is most suitable for you. […] The main treatments are: […] cryotherapy liquid nitrogen is sprayed on to the affected skin to freeze it. The procedure may be painful and the skin may remain a bit uncomfortable for a few days. The affected skin will scab over and fall off within a few weeks. […] imiquimod cream or chemotherapy cream (such as 5-fluorouracil) this is applied to the affected skin regularly for a few weeks. It may cause your skin to become red and inflamed before it gets better. […] curettage and cautery the affected area of skin is scraped away under local anaesthetic, where the skin is numbed, and heat or electricity is used to stop any bleeding, leaving the area to scab over and heal after a few weeks.

• #52 Bowen’s disease (severe sun damage) – MySkinDoctor

  https://www.myskindoctor.co.uk/bowens-disease-severe-sun-damage/

  A number of treatments are available for bowens disease: […] In many older patients with multiple lesions on the lower legs or in those patients with extensive sun damage no further treatment is required. Any symptoms such as itch or scaling may improved with the use of moisturising creams. […] Cryotherapy is usually only available in specialist clinics. It involves spraying cold liquid nitrogen on the surface of the skin for 10-12 seconds. This is a painful treatment causing skin redness, puffiness, blistering or crusting, and may be slow to heal. […] Efudix is a very effective treatment that can be prescribed by your primary care doctor. It works by destroying abnormal skin cells allowing healthy skin to heal from underneath. […] This involves scraping off the abnormal skin under a local anaesthetic with a device called a curette.

• #53 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  Photodynamic therapy (PDT) has also been used, with variable success, for the treatment of Bowen disease. […] This surgery is the most common and preferred treatment for smaller lesions and those not in problematic areas, such as the face and digits. […] Mohs micrographic surgery is an excellent method for larger lesions, poorly demarcated lesions, recurrent lesions on the head and neck, or areas where tissue sparing is vital, such as digital or genital lesions. […] Curettage and electrodesiccation, cryotherapy, and laser ablation are established treatment modalities for Bowen disease. […] Treatment efficacy is largely determined by the skill of the clinician. […] Cryotherapy is another common therapeutic option, especially for single and small lesions. […] Case reports and series have shown a benefit of using argon, carbon dioxide, and Nd:YAG lasers in the treatment of some Bowen disease lesions.

• #54 Bowen’s Disease Treatment |Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/bowens-disease/

  Cryotherapy alone also has a failure rate of up to 30%. […] Curettage and cautery (electrodessication and curettage, EDC) may be preferable to cryotherapy in terms of pain, healing, and recurrence rate (up to 20% with EDC). […] Photodynamic therapy (PDT) is also successful with Bowens disease by the virtue of being able to treat large areas. […] Various radiotherapy techniques have been used to treat Bowens disease. […] Finally, Mohs surgery remains the gold standard for treatment of Bowens disease except for small trunk and extremity lesions. […] Topical and destructive therapies have the potential to partially clear the lesion creating noncontiguous skip tumors.

• #55 Interventions for cutaneous Bowen’s disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6464151/

  Photodynamic therapy appears to be an effective treatment and has the benefit of minimal scarring compared with cryotherapy or 5-fluorouracil. […] Specific recommendations cannot be made from these data, so this review cannot give firm conclusions about the comparative effectiveness of treatments. […] The lack of quality data for surgery and topical cream therapies has limited the scope of this review to one largely about PDT studies. […] Overall, there has been very little good-quality research on treatments for Bowen’s disease. There is limited evidence from single studies to suggest MALPDT is an effective treatment. […] Significantly more lesions cleared with MALPDT compared to cryotherapy. […] No significant difference in clearance was seen when MALPDT was compared with 5FU, but one study found a significant difference in clearance in favour of ALAPDT when compared to 5FU. […] The age group, number, and size of lesions and site(s) affected may all influence therapeutic choice; however, there was not enough evidence available to provide guidance on this. […] More studies are required in the immunosuppressed populations as different therapeutic options may be preferable.

• #56 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  This paper is focused on the newer treatment options for BD: topical diclofenac and imiquimod and photodynamic therapy. […] In conclusion cryotherapy with liquid nitrogen is an effective, commonly used option in the treatment of BD entailing only low costs. […] In summary curettage and cautery is a safe and effective therapy of BD with a very good cost-benefit analysis. […] In conclusion surgical excision of BD is one of the standard treatments especially for small and single, digital and perianal BD. […] In summary the commercially available 5% 5-FU preparation has shown its efficacy in short- and long-term studies and can be used for the treatment of BD in good or even bad healing sites and for special sites like fingers or penis. […] In conclusion radiotherapy should not be used for poor healing sites (especially not for the lower leg) but it can be an alternative with high efficacy when other treatment options (eg, surgery) are difficult or not possible.

• #57 Analysis on the Effectiveness and Characteristics of Treatment Modalities for Bowen’s Disease: An Observational Study

  https://www.mdpi.com/2077-0383/11/10/2741

  Treatment options for Bowen’s disease (BD) include surgical excision, cryotherapy, curettage with cautery, topical 5-fluorouracil or imiquimod, and photodynamic therapy. […] The therapeutic efficacy was highest in the surgical excision group (100%) and lowest in the PDT group (62.5%). […] Surgical excision exhibited the highest clearance rate and the lowest recurrence rate, and its treatment period was the shortest, confirming that it remains the gold standard. […] In contrast, since cryotherapy demonstrated a relatively high recurrence rate including development of satellite lesions, careful monitoring is required when performing cryotherapy for treatment of BD. […] Surgical excision was involved in only 4.9% of treatment failure, which is defined as clinical evidence of residual tumor or tumor recurrence.

• #58 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 the affected area is very small, it may be possible to treat Bowens disease by freezing it. This is called cryotherapy or cryosurgery. A dermatologist will carefully spray liquid nitrogen onto the area to freeze and destroy the abnormal cells. […] Curettage is when a skin specialist doctor (dermatologist) scrapes away the affected area. They then use heat or electricity to stop any bleeding. This is called electrocautery. […] Doctors may use surgery to remove areas of Bowens disease, using a local anaesthetic. Surgery may be used to remove deeper areas, or if other treatments have not been successful. […] Laser treatment uses intense light energy to remove tissue. It is sometimes used to treat Bowen’s disease that affects the fingers or genitals. […] Radiotherapy uses high-energy x-rays to treat abnormal cells. It is sometimes used if Bowens disease is causing symptoms such as pain or bleeding.

• #59 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 the affected area is very small, it may be possible to treat Bowens disease by freezing it. This is called cryotherapy or cryosurgery. A dermatologist will carefully spray liquid nitrogen onto the area to freeze and destroy the abnormal cells. […] Curettage is when a skin specialist doctor (dermatologist) scrapes away the affected area. They then use heat or electricity to stop any bleeding. This is called electrocautery. […] Doctors may use surgery to remove areas of Bowens disease, using a local anaesthetic. Surgery may be used to remove deeper areas, or if other treatments have not been successful. […] Laser treatment uses intense light energy to remove tissue. It is sometimes used to treat Bowen’s disease that affects the fingers or genitals. […] Radiotherapy uses high-energy x-rays to treat abnormal cells. It is sometimes used if Bowens disease is causing symptoms such as pain or bleeding.

• #60 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  For specific guidelines and recommendations, please see British Association of Dermatologists guidelines for the management of people with squamous cell carcinoma in situ (Bowens disease) 2022. […] Each treatment modality has advantages and disadvantages. Choosing the best therapeutic option involves an analysis of various factors such as lesional size, number, site, degree of functional impairment, modality availability, and cost. […] 5-Fluorouracil is a topical antineoplastic agent that interferes with DNA synthesis via inhibition of thymidylate synthetase and subsequently cell proliferation. […] Imiquimod 5% cream, a topical immune response modifier, applied 3-7 d/wk, appears to possibly be a successful treatment option for Bowen disease. […] Consider x-ray or grenz-ray radiation therapy for poor surgical candidates or patients with multiple lesions.

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

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

  Bowen’s disease treatment […] 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. […] Surgery is the most common treatment and topical treatments are the most widely available. […] Topical 5-fluorouracil (5-FU) cream is a cytotoxic agent and is one of the first-line therapies available. […] Imiquimod 5% cream is an immune response modifying agent. […] Liquid nitrogen is used to freeze the lesion. […] Curettage with cautery: abnormal skin is scraped off under local anaesthetic and any additional tissue destroyed with electrocautery. […] Surgical excision is simple, quick and effective although may not be suitable for some parts of the body. […] Mohs’ microsurgery is used in areas such as fingers, nails or the penis where tissue-sparing techniques are required. […] PDT is the most studied treatment for Bowen’s disease. […] Various radiotherapy techniques are used in areas unsuitable for other treatment options.

• #62 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  This paper is focused on the newer treatment options for BD: topical diclofenac and imiquimod and photodynamic therapy. […] In conclusion cryotherapy with liquid nitrogen is an effective, commonly used option in the treatment of BD entailing only low costs. […] In summary curettage and cautery is a safe and effective therapy of BD with a very good cost-benefit analysis. […] In conclusion surgical excision of BD is one of the standard treatments especially for small and single, digital and perianal BD. […] In summary the commercially available 5% 5-FU preparation has shown its efficacy in short- and long-term studies and can be used for the treatment of BD in good or even bad healing sites and for special sites like fingers or penis. […] In conclusion radiotherapy should not be used for poor healing sites (especially not for the lower leg) but it can be an alternative with high efficacy when other treatment options (eg, surgery) are difficult or not possible.

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

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

  Cryosurgery. Cryosurgery, or cryotherapy, uses extreme cold to kill your abnormal skin cells. It typically uses liquid nitrogen or argon gas. Generally, this treatment is recommended if you have one lesion at a location on your body that heals well. […] Curettage with electrocautery. Curettage is a surgical procedure. It involves scraping the lesions off of your skin. After curettage, your lesion might be burned with an electrical current. This is called cauterization. […] Radiotherapy. Radiotherapy uses high doses of radiation to destroy the lesion. Types of radiotherapy used for Bowens disease include: external beam radiotherapy, a radioactive skin patch, Grenz rays. Radiotherapy is often used for lesions on areas that are hard to treat, such as your scalp, penis if you have one, and around your anus. Radiotherapy is one of the more expensive treatment options.

• #64 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 the affected area is very small, it may be possible to treat Bowens disease by freezing it. This is called cryotherapy or cryosurgery. A dermatologist will carefully spray liquid nitrogen onto the area to freeze and destroy the abnormal cells. […] Curettage is when a skin specialist doctor (dermatologist) scrapes away the affected area. They then use heat or electricity to stop any bleeding. This is called electrocautery. […] Doctors may use surgery to remove areas of Bowens disease, using a local anaesthetic. Surgery may be used to remove deeper areas, or if other treatments have not been successful. […] Laser treatment uses intense light energy to remove tissue. It is sometimes used to treat Bowen’s disease that affects the fingers or genitals. […] Radiotherapy uses high-energy x-rays to treat abnormal cells. It is sometimes used if Bowens disease is causing symptoms such as pain or bleeding.

• #65 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 the affected area is very small, it may be possible to treat Bowens disease by freezing it. This is called cryotherapy or cryosurgery. A dermatologist will carefully spray liquid nitrogen onto the area to freeze and destroy the abnormal cells. […] Curettage is when a skin specialist doctor (dermatologist) scrapes away the affected area. They then use heat or electricity to stop any bleeding. This is called electrocautery. […] Doctors may use surgery to remove areas of Bowens disease, using a local anaesthetic. Surgery may be used to remove deeper areas, or if other treatments have not been successful. […] Laser treatment uses intense light energy to remove tissue. It is sometimes used to treat Bowen’s disease that affects the fingers or genitals. […] Radiotherapy uses high-energy x-rays to treat abnormal cells. It is sometimes used if Bowens disease is causing symptoms such as pain or bleeding.

• #66 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  Photodynamic therapy (PDT) has also been used, with variable success, for the treatment of Bowen disease. […] This surgery is the most common and preferred treatment for smaller lesions and those not in problematic areas, such as the face and digits. […] Mohs micrographic surgery is an excellent method for larger lesions, poorly demarcated lesions, recurrent lesions on the head and neck, or areas where tissue sparing is vital, such as digital or genital lesions. […] Curettage and electrodesiccation, cryotherapy, and laser ablation are established treatment modalities for Bowen disease. […] Treatment efficacy is largely determined by the skill of the clinician. […] Cryotherapy is another common therapeutic option, especially for single and small lesions. […] Case reports and series have shown a benefit of using argon, carbon dioxide, and Nd:YAG lasers in the treatment of some Bowen disease lesions.

• #67 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #68 Pillar | Medanta

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

  A precise method for treating Bowen’s disease, laser therapy targets and destroys abnormal cells using a focused laser beam. It’s especially useful for lesions in challenging or cosmetically sensitive areas. […] After successfully treating Bowen’s disease, continuous care and regular check-ups with a dermatologist are crucial. The risk of it returning and new lesions forming necessitates long-term monitoring. […] Patients should also practise safeguarding their skin from the sun and examining it for any alarming changes. […] The main risk factor for Bowen’s disease is sun exposure to ultraviolet (UV) radiation. Hence, patients should shield their skin by donning protective attire, applying sunscreen, and avoiding direct sunlight during peak hours. […] Routinely inspecting one’s skin allows individuals to keep track of any new or changing lesions. If they detect any suspicious alterations, they should seek immediate medical attention. […] Consistent follow-up appointments with a dermatologist are indispensable, particularly in the initial years post-treatment. These visits enable healthcare providers to identify any signs of recurrence and address any patient concerns.

• #69 Treatment of Bowen Disease With Photodynamic Therapy and the Advantages of Sequential Topical Imiquimod | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-treatment-bowen-disease-with-photodynamic-articulo-S1578219016303419

  Photodynamic therapy (PDT) has been shown to be useful and effective in the treatment of actinic keratosis, Bowen disease, and basal cell carcinoma. […] PDT in monotherapy or combined sequentially with imiquimod is an excellent and well-tolerated therapeutic option for Bowen disease. The treatment has few adverse effects and shows satisfactory results, particularly in multiple large lesions in areas of difficult surgical reconstruction or in elderly patients with a high surgical risk. […] Several treatment options exist, including surgery, electrocoagulation, cryotherapy, 5-fluorouacil, 5% imiquimod, laser therapy, radiation therapy, and photodynamic therapy (PDT). […] PDT is approved for the treatment of actinic keratosis, superficial and nodular basal cell carcinoma (BCC), and BD. It is a simple technique, suitable for outpatient use, and has proven to be both useful and effective in BD.

• #70 Treatment of Bowen Disease With Photodynamic Therapy and the Advantages of Sequential Topical Imiquimod | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-treatment-bowen-disease-with-photodynamic-articulo-S1578219016303419

  Topical 5% imiquimod has also been used in the treatment of BD. It has been combined with PDT to treat diverse forms of non-melanoma skin cancer, including BD, and the combination appears to have a synergic effect. […] In conclusion, PDT is an excellent treatment option for BD, particularly in patients with larger or multiple lesions or elderly patients with a high surgical risk. In our experience, the sequential use of PDT and imiquimod induces improved clinical and histologic response. Both treatments are well tolerated, cause minimum adverse effects, and produce satisfactory cosmetic outcomes.

• #71 Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

  https://www.mdpi.com/2227-9059/12/4/795

  Photodynamic therapy is a first-line option for the treatment of Bowen’s disease. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Treatment options for Bowen’s disease are multiple, including surgical excision, cryotherapy, laser ablation, curettage with cautery, radiation therapy, topical 5% 5-fluorouracil (5-FU), imiquimod, and conventional photodynamic therapy (PDT). Current European guidelines recommend MAL-PDT for the treatment of Bowen’s disease with a strength of recommendation A and quality of evidence 1. PDT is particularly indicated for lesions at sites of poor healing, for large or multiple lesions, and in cases where surgery would be difficult or invasive such as facial, digital, nail bed, and penile lesions. The protocol involves two MAL-PDT sessions 7 days apart, repeated at 3 months, if necessary. The first large pan European study on MAL-PDT included 225 patients with histologically confirmed Bowen’s disease, randomized to MAL-PDT, cryotherapy, or topical 5% 5-FU for 4 weeks. After 3 months, lesion response rates were similar with all regimens (93% MAL-PDT, 86% cryotherapy, 83% 5-FU). Overall, the clinical response rate for MAL-PDT in the treatment of Bowen’s disease varies from 88–100% after one or two cycles at 3 months, with 68–89% of lesions clear over follow-up periods of 17–50 months. PDT has been combined with an ablative fractional resurfacing laser, CO2 laser, electrodessication, surgery, radiation, imiquimod, plum-blossom needle, and simple shaving for Bowen’s disease treatment. Combination therapy with laser-assisted techniques has been consistently demonstrated to effectively increase the penetration depth of the photosensitizer as well as increase PDT’s therapeutic effect. PDT is a safe and effective, well-established treatment option for Bowen’s disease, especially in difficult locations, large or multiple lesions, and elderly patients. The cosmetic outcome of MAL-PDT compares favorably with cryotherapy and 5% 5-FU with high levels of patient satisfaction. Patients with Bowen’s disease treated with PDT should be monitored after treatment because of the risk of incomplete response and recurrence, as well as progression to invasive cSCC, particularly for immunocompromised patients.

• #72 Bowen’s Disease Treatment |Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/bowens-disease/

  Contact SCARS Center of Orange Country for Bowens disease treatment. […] Most therapeutic options for Bowens disease, except Mohs excision, have failure and recurrence rate of 10%-20%, and no treatment modality is best in all clinical scenarios. […] 5-fluorouracil (5-FU) is usually applied once or twice daily as a 5% cream for up to 2 months and can be repeated if needed. […] The median clearance rate with 5-FU among the studies is 80-90% with 10-20% recurrence rate. […] Imiquimod (Aldara) has the unique role as both an anti-tumor agent and an anti-viral agent given its immunomodulating action. […] Imiquimod applied daily for 16 weeks produced a cure rate between 73% and 93% in several studies. […] An innovative approach obtained 100% cure rate utilizing cryoimmunotherapy in a single study.

• #73 Lee Clinic Dermatology Cork | Bowens Disease

  https://www.leeclinicdermatology.ie/m/dermatology-cork/common-skin-conditions/bowens-disease

  Imiquimod (Aldara) cream. This was originally developed for the treatment of genital warts, but imiquimod cream has been found useful in treating Bowens disease. It also causes inflammation of the skin during treatment. […] Photodynamic therapy. A chemical is applied to the skin that makes the cells in the patch of Bowens disease sensitive to particular wavelengths of light. Light from a special lamp is then shone onto the lesion. This treatment can be painful and cause inflammation; however any inflammation should disappear within a few days. […] A particular problem with Bowens disease is that it is frequently found on the lower leg – where the skin is often tight and sometimes quite fragile, especially in older patients. Healing there is slow. Many factors, therefore, play a part in selecting the right treatment: […] If the affected area is judged to be thin and not likely to cause problems soon, your dermatologist may simply suggest that it is kept under observation in a clinic, or in some cases by yourself or by your GP.

• #74 Lee Clinic Dermatology Cork | Bowens Disease

  https://www.leeclinicdermatology.ie/m/dermatology-cork/common-skin-conditions/bowens-disease

  Imiquimod (Aldara) cream. This was originally developed for the treatment of genital warts, but imiquimod cream has been found useful in treating Bowens disease. It also causes inflammation of the skin during treatment. […] Photodynamic therapy. A chemical is applied to the skin that makes the cells in the patch of Bowens disease sensitive to particular wavelengths of light. Light from a special lamp is then shone onto the lesion. This treatment can be painful and cause inflammation; however any inflammation should disappear within a few days. […] A particular problem with Bowens disease is that it is frequently found on the lower leg – where the skin is often tight and sometimes quite fragile, especially in older patients. Healing there is slow. Many factors, therefore, play a part in selecting the right treatment: […] If the affected area is judged to be thin and not likely to cause problems soon, your dermatologist may simply suggest that it is kept under observation in a clinic, or in some cases by yourself or by your GP.

• #75 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

  Bowens disease often grows very slowly, over a period of months or years. Sometimes a thin patch of Bowens that does not change will never cause a problem. In this case, your dermatologist may advise you to keep checking it for changes instead of giving you treatment. You may also have regular check-ups with your doctor to monitor it carefully.

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

  https://patient.info/cancer/skin-cancer-types/bowens-disease

  What is the treatment for Bowen’s disease? […] Treatment can depend on a number of different things, including the site of the patch of Bowen’s disease, its size and thickness and how many Bowen’s disease patches you have. […] The treatment options include: […] Observation (’watch and wait’) […] This may be an option in some people. For example, this may be advised if you have a slowly growing, thin patch of Bowen’s disease on an area of your body where skin healing may be difficult (such as your shin). […] Certain creams may be used in the treatment of Bowen’s disease. These can help to kill and get rid of the abnormal cells in some cases. Such creams include 5-fluorouracil (5-FU), a type of chemotherapy cream. […] 5-FU cream may need to be applied once or twice a day for around three to four weeks and sometimes for longer.

• #77 Bowen’s disease (severe sun damage) – MySkinDoctor

  https://www.myskindoctor.co.uk/bowens-disease-severe-sun-damage/

  A number of treatments are available for bowens disease: […] In many older patients with multiple lesions on the lower legs or in those patients with extensive sun damage no further treatment is required. Any symptoms such as itch or scaling may improved with the use of moisturising creams. […] Cryotherapy is usually only available in specialist clinics. It involves spraying cold liquid nitrogen on the surface of the skin for 10-12 seconds. This is a painful treatment causing skin redness, puffiness, blistering or crusting, and may be slow to heal. […] Efudix is a very effective treatment that can be prescribed by your primary care doctor. It works by destroying abnormal skin cells allowing healthy skin to heal from underneath. […] This involves scraping off the abnormal skin under a local anaesthetic with a device called a curette.

• #78 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. […] There are many ways to treat Bowen’s disease. […] Because it is such an early cancer, it can usually be cured. […] The best type of treatment for you will depend on: the size and thickness of the Bowen’s disease, where it is on your body, your age, your health in general. […] You can choose what treatment to have. […] Sometimes, Bowen’s disease comes back after treatment. It is important to go to follow-up appointments with your doctor or dermatologist. […] Freezing it off (cryotherapy): Liquid nitrogen is sprayed onto the patch of skin to freeze it. It will scab over and fall off after a few days. This procedure can be a little uncomfortable. […] Chemotherapy cream: A medicine such as 5-fluorouracil or imiquimod is put on the patch. You need to use the cream regularly for a few weeks. The skin often gets red and inflamed before it gets better.

• #79 Lee Clinic Dermatology Cork | Bowens Disease

  https://www.leeclinicdermatology.ie/m/dermatology-cork/common-skin-conditions/bowens-disease

  Imiquimod (Aldara) cream. This was originally developed for the treatment of genital warts, but imiquimod cream has been found useful in treating Bowens disease. It also causes inflammation of the skin during treatment. […] Photodynamic therapy. A chemical is applied to the skin that makes the cells in the patch of Bowens disease sensitive to particular wavelengths of light. Light from a special lamp is then shone onto the lesion. This treatment can be painful and cause inflammation; however any inflammation should disappear within a few days. […] A particular problem with Bowens disease is that it is frequently found on the lower leg – where the skin is often tight and sometimes quite fragile, especially in older patients. Healing there is slow. Many factors, therefore, play a part in selecting the right treatment: […] If the affected area is judged to be thin and not likely to cause problems soon, your dermatologist may simply suggest that it is kept under observation in a clinic, or in some cases by yourself or by your GP.

• #80 Bowen Disease Treatment & Management: Medical Care, Surgical Care, Prevention

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

  Photodynamic therapy (PDT) has also been used, with variable success, for the treatment of Bowen disease. […] This surgery is the most common and preferred treatment for smaller lesions and those not in problematic areas, such as the face and digits. […] Mohs micrographic surgery is an excellent method for larger lesions, poorly demarcated lesions, recurrent lesions on the head and neck, or areas where tissue sparing is vital, such as digital or genital lesions. […] Curettage and electrodesiccation, cryotherapy, and laser ablation are established treatment modalities for Bowen disease. […] Treatment efficacy is largely determined by the skill of the clinician. […] Cryotherapy is another common therapeutic option, especially for single and small lesions. […] Case reports and series have shown a benefit of using argon, carbon dioxide, and Nd:YAG lasers in the treatment of some Bowen disease lesions.

• #81 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 the affected area is very small, it may be possible to treat Bowens disease by freezing it. This is called cryotherapy or cryosurgery. A dermatologist will carefully spray liquid nitrogen onto the area to freeze and destroy the abnormal cells. […] Curettage is when a skin specialist doctor (dermatologist) scrapes away the affected area. They then use heat or electricity to stop any bleeding. This is called electrocautery. […] Doctors may use surgery to remove areas of Bowens disease, using a local anaesthetic. Surgery may be used to remove deeper areas, or if other treatments have not been successful. […] Laser treatment uses intense light energy to remove tissue. It is sometimes used to treat Bowen’s disease that affects the fingers or genitals. […] Radiotherapy uses high-energy x-rays to treat abnormal cells. It is sometimes used if Bowens disease is causing symptoms such as pain or bleeding.

• #82 Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

  https://www.mdpi.com/2227-9059/12/4/795

  Photodynamic therapy is a first-line option for the treatment of Bowen’s disease. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Treatment options for Bowen’s disease are multiple, including surgical excision, cryotherapy, laser ablation, curettage with cautery, radiation therapy, topical 5% 5-fluorouracil (5-FU), imiquimod, and conventional photodynamic therapy (PDT). Current European guidelines recommend MAL-PDT for the treatment of Bowen’s disease with a strength of recommendation A and quality of evidence 1. PDT is particularly indicated for lesions at sites of poor healing, for large or multiple lesions, and in cases where surgery would be difficult or invasive such as facial, digital, nail bed, and penile lesions. The protocol involves two MAL-PDT sessions 7 days apart, repeated at 3 months, if necessary. The first large pan European study on MAL-PDT included 225 patients with histologically confirmed Bowen’s disease, randomized to MAL-PDT, cryotherapy, or topical 5% 5-FU for 4 weeks. After 3 months, lesion response rates were similar with all regimens (93% MAL-PDT, 86% cryotherapy, 83% 5-FU). Overall, the clinical response rate for MAL-PDT in the treatment of Bowen’s disease varies from 88–100% after one or two cycles at 3 months, with 68–89% of lesions clear over follow-up periods of 17–50 months. PDT has been combined with an ablative fractional resurfacing laser, CO2 laser, electrodessication, surgery, radiation, imiquimod, plum-blossom needle, and simple shaving for Bowen’s disease treatment. Combination therapy with laser-assisted techniques has been consistently demonstrated to effectively increase the penetration depth of the photosensitizer as well as increase PDT’s therapeutic effect. PDT is a safe and effective, well-established treatment option for Bowen’s disease, especially in difficult locations, large or multiple lesions, and elderly patients. The cosmetic outcome of MAL-PDT compares favorably with cryotherapy and 5% 5-FU with high levels of patient satisfaction. Patients with Bowen’s disease treated with PDT should be monitored after treatment because of the risk of incomplete response and recurrence, as well as progression to invasive cSCC, particularly for immunocompromised patients.

• #83 Treatment of Bowen Disease With Photodynamic Therapy and the Advantages of Sequential Topical Imiquimod | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-treatment-bowen-disease-with-photodynamic-articulo-S1578219016303419

  Photodynamic therapy (PDT) has been shown to be useful and effective in the treatment of actinic keratosis, Bowen disease, and basal cell carcinoma. […] PDT in monotherapy or combined sequentially with imiquimod is an excellent and well-tolerated therapeutic option for Bowen disease. The treatment has few adverse effects and shows satisfactory results, particularly in multiple large lesions in areas of difficult surgical reconstruction or in elderly patients with a high surgical risk. […] Several treatment options exist, including surgery, electrocoagulation, cryotherapy, 5-fluorouacil, 5% imiquimod, laser therapy, radiation therapy, and photodynamic therapy (PDT). […] PDT is approved for the treatment of actinic keratosis, superficial and nodular basal cell carcinoma (BCC), and BD. It is a simple technique, suitable for outpatient use, and has proven to be both useful and effective in BD.

• #84 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #85 Treatment of Bowen Disease With Photodynamic Therapy and the Advantages of Sequential Topical Imiquimod | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-treatment-bowen-disease-with-photodynamic-articulo-S1578219016303419

  Topical 5% imiquimod has also been used in the treatment of BD. It has been combined with PDT to treat diverse forms of non-melanoma skin cancer, including BD, and the combination appears to have a synergic effect. […] In conclusion, PDT is an excellent treatment option for BD, particularly in patients with larger or multiple lesions or elderly patients with a high surgical risk. In our experience, the sequential use of PDT and imiquimod induces improved clinical and histologic response. Both treatments are well tolerated, cause minimum adverse effects, and produce satisfactory cosmetic outcomes.

• #86 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #87 Interventions for cutaneous Bowen’s disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6464151/

  Photodynamic therapy appears to be an effective treatment and has the benefit of minimal scarring compared with cryotherapy or 5-fluorouracil. […] Specific recommendations cannot be made from these data, so this review cannot give firm conclusions about the comparative effectiveness of treatments. […] The lack of quality data for surgery and topical cream therapies has limited the scope of this review to one largely about PDT studies. […] Overall, there has been very little good-quality research on treatments for Bowen’s disease. There is limited evidence from single studies to suggest MALPDT is an effective treatment. […] Significantly more lesions cleared with MALPDT compared to cryotherapy. […] No significant difference in clearance was seen when MALPDT was compared with 5FU, but one study found a significant difference in clearance in favour of ALAPDT when compared to 5FU. […] The age group, number, and size of lesions and site(s) affected may all influence therapeutic choice; however, there was not enough evidence available to provide guidance on this. […] More studies are required in the immunosuppressed populations as different therapeutic options may be preferable.

• #88 Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

  https://www.mdpi.com/2227-9059/12/4/795

  Photodynamic therapy is a first-line option for the treatment of Bowen’s disease. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Treatment options for Bowen’s disease are multiple, including surgical excision, cryotherapy, laser ablation, curettage with cautery, radiation therapy, topical 5% 5-fluorouracil (5-FU), imiquimod, and conventional photodynamic therapy (PDT). Current European guidelines recommend MAL-PDT for the treatment of Bowen’s disease with a strength of recommendation A and quality of evidence 1. PDT is particularly indicated for lesions at sites of poor healing, for large or multiple lesions, and in cases where surgery would be difficult or invasive such as facial, digital, nail bed, and penile lesions. The protocol involves two MAL-PDT sessions 7 days apart, repeated at 3 months, if necessary. The first large pan European study on MAL-PDT included 225 patients with histologically confirmed Bowen’s disease, randomized to MAL-PDT, cryotherapy, or topical 5% 5-FU for 4 weeks. After 3 months, lesion response rates were similar with all regimens (93% MAL-PDT, 86% cryotherapy, 83% 5-FU). Overall, the clinical response rate for MAL-PDT in the treatment of Bowen’s disease varies from 88–100% after one or two cycles at 3 months, with 68–89% of lesions clear over follow-up periods of 17–50 months. PDT has been combined with an ablative fractional resurfacing laser, CO2 laser, electrodessication, surgery, radiation, imiquimod, plum-blossom needle, and simple shaving for Bowen’s disease treatment. Combination therapy with laser-assisted techniques has been consistently demonstrated to effectively increase the penetration depth of the photosensitizer as well as increase PDT’s therapeutic effect. PDT is a safe and effective, well-established treatment option for Bowen’s disease, especially in difficult locations, large or multiple lesions, and elderly patients. The cosmetic outcome of MAL-PDT compares favorably with cryotherapy and 5% 5-FU with high levels of patient satisfaction. Patients with Bowen’s disease treated with PDT should be monitored after treatment because of the risk of incomplete response and recurrence, as well as progression to invasive cSCC, particularly for immunocompromised patients.

• #89 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #90 Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

  https://www.mdpi.com/2227-9059/12/4/795

  Photodynamic therapy is a first-line option for the treatment of Bowen’s disease. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Treatment options for Bowen’s disease are multiple, including surgical excision, cryotherapy, laser ablation, curettage with cautery, radiation therapy, topical 5% 5-fluorouracil (5-FU), imiquimod, and conventional photodynamic therapy (PDT). Current European guidelines recommend MAL-PDT for the treatment of Bowen’s disease with a strength of recommendation A and quality of evidence 1. PDT is particularly indicated for lesions at sites of poor healing, for large or multiple lesions, and in cases where surgery would be difficult or invasive such as facial, digital, nail bed, and penile lesions. The protocol involves two MAL-PDT sessions 7 days apart, repeated at 3 months, if necessary. The first large pan European study on MAL-PDT included 225 patients with histologically confirmed Bowen’s disease, randomized to MAL-PDT, cryotherapy, or topical 5% 5-FU for 4 weeks. After 3 months, lesion response rates were similar with all regimens (93% MAL-PDT, 86% cryotherapy, 83% 5-FU). Overall, the clinical response rate for MAL-PDT in the treatment of Bowen’s disease varies from 88–100% after one or two cycles at 3 months, with 68–89% of lesions clear over follow-up periods of 17–50 months. PDT has been combined with an ablative fractional resurfacing laser, CO2 laser, electrodessication, surgery, radiation, imiquimod, plum-blossom needle, and simple shaving for Bowen’s disease treatment. Combination therapy with laser-assisted techniques has been consistently demonstrated to effectively increase the penetration depth of the photosensitizer as well as increase PDT’s therapeutic effect. PDT is a safe and effective, well-established treatment option for Bowen’s disease, especially in difficult locations, large or multiple lesions, and elderly patients. The cosmetic outcome of MAL-PDT compares favorably with cryotherapy and 5% 5-FU with high levels of patient satisfaction. Patients with Bowen’s disease treated with PDT should be monitored after treatment because of the risk of incomplete response and recurrence, as well as progression to invasive cSCC, particularly for immunocompromised patients.

• #91 Treatments for cutaneous Bowen’s disease | Cochrane

  https://www.cochrane.org/CD007281/SKIN_treatments-cutaneous-bowens-disease

  Treatments for cutaneous Bowen’s disease […] This review attempted to find which is the most effective treatment for cutaneous Bowen’s disease, with the least side-effects. […] There are a range of treatment options including the following: topical therapies, such as 5-fluorouracil (5-FU) and imiquimod creams; surgical interventions, such as excision and Mohs micrographic surgery; destructive therapies, such as cryotherapy (freezing); and light-based therapies, such as photodynamic therapy (where a light-sensitive cream is used in combination with visible light). […] Photodynamic therapy appears to be an effective treatment and has the benefit of minimal scarring compared with cryotherapy or 5-fluorouracil. […] 5-aminolevulinic acid with photodynamic therapy (ALA-PDT) appears to be more effective than 5-fluorouracil, whereas methyl aminolevulinate with photodynamic therapy (MAL-PDT) does not appear to be as good as 5-fluorouracil.

• #92 Recurrent Bowen’s Disease of Temple – Skin Cancer and Reconstructive Surgery Center

  https://scarscenter.com/patient-case-studies/recurrent-bowens-disease-of-temple/

  Management of this lesion is best treated with a topical agent such as 5-fluorouracil or imiquimod. […] The choice for topical therapy is 5-fluorouracil (5-FU), a chemotherapeutic agent, or imiquimod, an immune response stimulant. […] Photodynamic therapy (PDT) is also an effective treatment for a larger field as this. […] Some studies had shown PDT to be more effective with fewer adverse outcomes than topical creams. […] Curettage or cryotherapy can be equally effective, albeit with worse cosmetic outcome and in some case prolonged healing.

• #93 Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

  https://www.mdpi.com/2227-9059/12/4/795

  Photodynamic therapy is a first-line option for the treatment of Bowen’s disease. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Treatment options for Bowen’s disease are multiple, including surgical excision, cryotherapy, laser ablation, curettage with cautery, radiation therapy, topical 5% 5-fluorouracil (5-FU), imiquimod, and conventional photodynamic therapy (PDT). Current European guidelines recommend MAL-PDT for the treatment of Bowen’s disease with a strength of recommendation A and quality of evidence 1. PDT is particularly indicated for lesions at sites of poor healing, for large or multiple lesions, and in cases where surgery would be difficult or invasive such as facial, digital, nail bed, and penile lesions. The protocol involves two MAL-PDT sessions 7 days apart, repeated at 3 months, if necessary. The first large pan European study on MAL-PDT included 225 patients with histologically confirmed Bowen’s disease, randomized to MAL-PDT, cryotherapy, or topical 5% 5-FU for 4 weeks. After 3 months, lesion response rates were similar with all regimens (93% MAL-PDT, 86% cryotherapy, 83% 5-FU). Overall, the clinical response rate for MAL-PDT in the treatment of Bowen’s disease varies from 88–100% after one or two cycles at 3 months, with 68–89% of lesions clear over follow-up periods of 17–50 months. PDT has been combined with an ablative fractional resurfacing laser, CO2 laser, electrodessication, surgery, radiation, imiquimod, plum-blossom needle, and simple shaving for Bowen’s disease treatment. Combination therapy with laser-assisted techniques has been consistently demonstrated to effectively increase the penetration depth of the photosensitizer as well as increase PDT’s therapeutic effect. PDT is a safe and effective, well-established treatment option for Bowen’s disease, especially in difficult locations, large or multiple lesions, and elderly patients. The cosmetic outcome of MAL-PDT compares favorably with cryotherapy and 5% 5-FU with high levels of patient satisfaction. Patients with Bowen’s disease treated with PDT should be monitored after treatment because of the risk of incomplete response and recurrence, as well as progression to invasive cSCC, particularly for immunocompromised patients.

• #94 Bowen's disease

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

  Although the risk of leg ulceration is greater with cryosurgery, it can also happen with Efudix cream, as such a watch and wait policy can be offered for lesions on the gaiter area of the legs in patients with a reduced life expectancy. […] Photodynamic therapy (where available) – can be very useful for large and multiple lesions, and can be used on almost any body site. […] Patients should be followed up at three months. The presence of any remaining rough scale would suggest that the lesion has not fully responsed 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.

• #95 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. […] There are many ways to treat Bowen’s disease. […] Because it is such an early cancer, it can usually be cured. […] The best type of treatment for you will depend on: the size and thickness of the Bowen’s disease, where it is on your body, your age, your health in general. […] You can choose what treatment to have. […] Sometimes, Bowen’s disease comes back after treatment. It is important to go to follow-up appointments with your doctor or dermatologist. […] Freezing it off (cryotherapy): Liquid nitrogen is sprayed onto the patch of skin to freeze it. It will scab over and fall off after a few days. This procedure can be a little uncomfortable. […] Chemotherapy cream: A medicine such as 5-fluorouracil or imiquimod is put on the patch. You need to use the cream regularly for a few weeks. The skin often gets red and inflamed before it gets better.

• #96 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Bowens-Disease-Squamous-Cell-Carcinoma-in-Situ.aspx

  Surgery: The general procedure includes cutting out of lesions and suturing the skin. This treatment has a success rate of 100% but with a major drawback of leaving a surgical scar. […] Radiation therapy: The lesions of the skin are treated with X-rays; this technique is not widely used as the healing process is much difficult. […] There are multiple treatment procedures for Bowen’s disease; however, the chances of recurrence are approximately one in ten. Hence, a routine follow-up is required to check for signs of reappearance. Additional treatment may be suggested if this recurrence happens. […] The prognosis of people with Bowen’s skin condition is generally good. The majority of people who are treated and completely recovered from Bowen’s disease do not have any chances of developing a skin cancer.

• #97 Bowen’s disease (severe sun damage) – MySkinDoctor

  https://www.myskindoctor.co.uk/bowens-disease-severe-sun-damage/

  The abnormal skin can be cut out, under local anaesthetic, provided it is not too large. […] A chemical is applied to the skin that makes the cells in the patch of Bowens disease sensitive to particular wavelengths of light. […] It is important to use high-factor sun-screens (SPF50) on a regular basis and generally protect your skin from the sun. […] Treatments depend on the location, size, and thickness of assessed skin lesions. Higher risk lesions include larger lesions and those that are changing. Treatment options can always be discussed with a member of the specialist team. Conservative management is often the best option in older patients unless skin cancer is suspected.

• #98 Pillar | Medanta

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

  A precise method for treating Bowen’s disease, laser therapy targets and destroys abnormal cells using a focused laser beam. It’s especially useful for lesions in challenging or cosmetically sensitive areas. […] After successfully treating Bowen’s disease, continuous care and regular check-ups with a dermatologist are crucial. The risk of it returning and new lesions forming necessitates long-term monitoring. […] Patients should also practise safeguarding their skin from the sun and examining it for any alarming changes. […] The main risk factor for Bowen’s disease is sun exposure to ultraviolet (UV) radiation. Hence, patients should shield their skin by donning protective attire, applying sunscreen, and avoiding direct sunlight during peak hours. […] Routinely inspecting one’s skin allows individuals to keep track of any new or changing lesions. If they detect any suspicious alterations, they should seek immediate medical attention. […] Consistent follow-up appointments with a dermatologist are indispensable, particularly in the initial years post-treatment. These visits enable healthcare providers to identify any signs of recurrence and address any patient concerns.

• #99 Pillar | Medanta

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

  A precise method for treating Bowen’s disease, laser therapy targets and destroys abnormal cells using a focused laser beam. It’s especially useful for lesions in challenging or cosmetically sensitive areas. […] After successfully treating Bowen’s disease, continuous care and regular check-ups with a dermatologist are crucial. The risk of it returning and new lesions forming necessitates long-term monitoring. […] Patients should also practise safeguarding their skin from the sun and examining it for any alarming changes. […] The main risk factor for Bowen’s disease is sun exposure to ultraviolet (UV) radiation. Hence, patients should shield their skin by donning protective attire, applying sunscreen, and avoiding direct sunlight during peak hours. […] Routinely inspecting one’s skin allows individuals to keep track of any new or changing lesions. If they detect any suspicious alterations, they should seek immediate medical attention. […] Consistent follow-up appointments with a dermatologist are indispensable, particularly in the initial years post-treatment. These visits enable healthcare providers to identify any signs of recurrence and address any patient concerns.

• #100 Pillar | Medanta

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

  A precise method for treating Bowen’s disease, laser therapy targets and destroys abnormal cells using a focused laser beam. It’s especially useful for lesions in challenging or cosmetically sensitive areas. […] After successfully treating Bowen’s disease, continuous care and regular check-ups with a dermatologist are crucial. The risk of it returning and new lesions forming necessitates long-term monitoring. […] Patients should also practise safeguarding their skin from the sun and examining it for any alarming changes. […] The main risk factor for Bowen’s disease is sun exposure to ultraviolet (UV) radiation. Hence, patients should shield their skin by donning protective attire, applying sunscreen, and avoiding direct sunlight during peak hours. […] Routinely inspecting one’s skin allows individuals to keep track of any new or changing lesions. If they detect any suspicious alterations, they should seek immediate medical attention. […] Consistent follow-up appointments with a dermatologist are indispensable, particularly in the initial years post-treatment. These visits enable healthcare providers to identify any signs of recurrence and address any patient concerns.

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

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

  Bowen’s disease treatment […] 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. […] Surgery is the most common treatment and topical treatments are the most widely available. […] Topical 5-fluorouracil (5-FU) cream is a cytotoxic agent and is one of the first-line therapies available. […] Imiquimod 5% cream is an immune response modifying agent. […] Liquid nitrogen is used to freeze the lesion. […] Curettage with cautery: abnormal skin is scraped off under local anaesthetic and any additional tissue destroyed with electrocautery. […] Surgical excision is simple, quick and effective although may not be suitable for some parts of the body. […] Mohs’ microsurgery is used in areas such as fingers, nails or the penis where tissue-sparing techniques are required. […] PDT is the most studied treatment for Bowen’s disease. […] Various radiotherapy techniques are used in areas unsuitable for other treatment options.

• #102 Bowen’s disease – a review of newer treatment options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2621408/

  In summary especially the CO2 laser can be used for penile or digital BD with only limited data of recurrence rates. […] In conclusion topical imiquimod 5% cream is an effective alternative treatment option for patients and body sites that are unsuitable for other treatments like surgery. […] In summary topical PDT in the treatment of BD is a therapy option with high efficacy and good cosmetic outcome. […] PDT is especially suited for poor-healing sites, patients with large and multiple lesions and patients with comorbidities (eg, diabetes, immunosupression, treatment with anticoagulants). […] Thus there is no single definite right way for all patients with BD, the choice of treatment should be guided by its efficacy, location and size of BD, number of lesions, availability of the therapy, the clinicians expertise, patient factors (age, immune status, concomitant medication, comorbidities and compliance), cosmetic outcome and the patients preference.

• #103 Analysis on the Effectiveness and Characteristics of Treatment Modalities for Bowen’s Disease: An Observational Study

  https://www.mdpi.com/2077-0383/11/10/2741

  Treatment options for Bowen’s disease (BD) include surgical excision, cryotherapy, curettage with cautery, topical 5-fluorouracil or imiquimod, and photodynamic therapy. […] The therapeutic efficacy was highest in the surgical excision group (100%) and lowest in the PDT group (62.5%). […] Surgical excision exhibited the highest clearance rate and the lowest recurrence rate, and its treatment period was the shortest, confirming that it remains the gold standard. […] In contrast, since cryotherapy demonstrated a relatively high recurrence rate including development of satellite lesions, careful monitoring is required when performing cryotherapy for treatment of BD. […] Surgical excision was involved in only 4.9% of treatment failure, which is defined as clinical evidence of residual tumor or tumor recurrence.

• #104 Analysis on the Effectiveness and Characteristics of Treatment Modalities for Bowen’s Disease: An Observational Study

  https://www.mdpi.com/2077-0383/11/10/2741

  Treatment options for Bowen’s disease (BD) include surgical excision, cryotherapy, curettage with cautery, topical 5-fluorouracil or imiquimod, and photodynamic therapy. […] The therapeutic efficacy was highest in the surgical excision group (100%) and lowest in the PDT group (62.5%). […] Surgical excision exhibited the highest clearance rate and the lowest recurrence rate, and its treatment period was the shortest, confirming that it remains the gold standard. […] In contrast, since cryotherapy demonstrated a relatively high recurrence rate including development of satellite lesions, careful monitoring is required when performing cryotherapy for treatment of BD. […] Surgical excision was involved in only 4.9% of treatment failure, which is defined as clinical evidence of residual tumor or tumor recurrence.

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

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

  As intraepidermal SCC is confined to the surface of the skin, there are various ways to remove it. Recurrence rates are high, whatever method is used, particularly in immune suppressed patients. […] Solitary lesions can be cut out, and the defect repaired by stitching it up. Excision is often recommended if there is suspicion of invasive SCC. […] Superficial skin surgery refers to shave, curettage and electrosurgery, and is an excellent choice for solitary or few hyperkeratotic lesions. The lesion is sliced off or scraped out; then the base is cauterised. Dressings are applied to the open wound to encourage moist wound healing over the next few weeks. […] Cryotherapy means removing a lesion by freezing it, usually with liquid nitrogen. Moderately aggressive cryotherapy is suitable for multiple, small, flat patches of intraepidermal SCC. It leaves a permanent white mark at the site of treatment.

• #106 Penile Bowen Disease: Is It Cancer?

  https://www.healthline.com/health/bowen-disease-penile-cancer

  Bowen disease exists in the topmost layer of your skin, making it highly treatable, even in locations like your penis. […] A doctor will decide on your treatment regime based on your overall health, the locations and size of the Bowen lesions, and any symptoms you’re experiencing. […] Your options include: topical chemotherapy creams, traditional surgical removal, cryotherapy, curettage with cautery/electrocautery, photodynamic therapy, radiotherapy. […] Radiotherapy is used less often in Bowen disease treatment compared with other methods, but no single therapy appears to be superior to the others. […] In a 2023 meta-analysis, photodynamic therapy was found to have less long-term success (more lesions recurred after 24-60 months) compared with surgery. […] Overall, the authors indicated the literature on Bowen treatments was too low quality to make a recommendation on a preferred treatment method. […] Topical treatments and procedures that remove Bowen lesions are highly successful.

• #107 Bowen’s disease | Skin cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/skin-cancer/types/bowens-disease

  There are several treatments for Bowen’s disease, such as: […] All these treatments can work well. The treatment you have will often depend on which part of your body is affected. Because there are many treatments and this is a very early type of skin cancer, the cure rates are high.

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

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

  Topical photodynamic therapy. In photodynamic therapy, a light-sensitizing agent is applied to your lesion for 3 hours. A light is then projected onto the targeted area, which selectively destroys the damage. […] There are multiple options for effective Bowens disease treatments. So, for most people, the recovery rate is high. […] It’s 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.

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