Bowens Disease: Information, Causes and Treatment

What is Bowens Disease?

A skin cancer, Bowens disease is also known as squamous cell carcinoma in situ or SCC in situ. The facts that this is a form of skin cancer that is only on the surface is referred to by the "in situ" at the end. Squamous cell carcinoma that grows inward and has the potential to spread is "invasive". The doctor responsible for the discovery over a hundred years ago is honored with the name Bowens disease.

Areas frequently exposed to the sun have a red scaly patch with SCC in situ and it can sometimes itch, crust or ooze. However, during most of the condition it is not associated with any kind of feeling. This type of skin cancer is often mistaken for a rash, eczema, fungus or psoriasis due to the red, scaly patches. It is important for a biopsy to be performed to confirm the diagnosis since they are sometime brown and may look like keratosis or melanoma, it should always be kept in mind that the earlier a diagnosis is made the better the chances are for recovery.

There is a higher than normal risk for other types of skin cancer for those who have had SCC in situ. It is important to have regular skin examinations by a dermatologist because of this increased risk. As time passes SCC in situ will become larger if not treated, sometimes spreading out over several inches. Invasive squamous cell carcinoma will develop in five percent of untreated SCC in situ cases.

What Causes Bowens Disease?

Persistent sun exposure and aging are the causes of Bowens Disease as they are with many other forms of skin cancer. There are two other identified causes that are unique to SCC in situ. These are HPV-16 which is the wart virus that causes cervical cancer which is often found to be infecting SCC in situ. This is why two people with the same amount of sun exposure will result in only one having repeated cases of skin cancers. The other factors that causes SCC in situ is arsenic, the poison the Russian villain Rasputin made famous. Some old water wells were contaminated many years ago when it was used in some medical elixirs. Mild arsenic poisoning didn't kill the people who suffered from it but they did have increased risk of developing skin and internal cancers. SCC in situ was at once time believed to be a warning of internal cancers developing, but later it was discovered that this was the result of the effects of arsenic poisoning.

Treatment for Bowens Disease

Surgical excision is the common treatment for small SCC in situ which involves the removal of approximately one quarter of an inch past the edge of the cancer. With larger cancers Mohs surgery has the highest rate of all known treatment methods and may be necessary although they can also have surgical excision.

There are still choices available for those who are not up to surgery. There are several methods capable of burning off SCC in situ which are called "curettage and electrodessication", liquid nitrogen cryotherapy and laser destruction, all of which have similar types of scars when they heal.

Multiple sites can be given X-ray or grenz ray radiation therapy if patients are poor surgical candidates, but these methods are both expensive and need several visits to the hospital. For one to three months the use of Efudex Cream often works however it usually leaves an uncomfortable, raw area while treatment is being done. Another promising option is Aldara Cream and while it has a good cure rate it is still in the process of undergoing studies to find the overall benefits of its use.

The FDA has recently approved a new treatment known as photodynamic therapy, but it is not yet ready for common use. PDT is another method that uses a drug to burn off SCC in situ by attacking only the cancer cells. The release of toxins is caused when a bright light is applied which in turn destroys the tumor.

A dermatologist is best equipped to decide the best course of treatment since they know your situation the best based on knowledge, experience and expertise. Protecting your skin from the sun with sun block that has at least SPF-15, wearing a wide brimmed hat and eating a healthy, low-fat diet is the best way to avoid skin cancer.

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