Bowen disease

Last Updated: 2020-11-19

Author(s): Anzengruber F., Navarini A.

ICD11: 2E64.00

Bowen 1912.

Bowen's disease, dyskeratosis maligna, carcinoma in situ, carcinoma in situ Bowen's disease type.

Carcinoma in situ, which originates from the keratinocytes. In the area of the genital mucosa, this is called erythroplasia.

Increased risk with increasing age
Especially in patients with light skin type

Triggers:

  • Cumulative UV radiation 
  • Arsenic 
  • Human Papillomaviruses
  • Mostly solitary, rather sharply defined, erythematous, centrifugally expanding, eczematous, scaly plaque. 
  • In 40% the skin change occurs solitary, in 60% multicenter. 
  • In the area of the mucous membranes, erosive, leukoplakia-like Bowen's disease can occur.

Transition to spinocellular carcinoma in up to 50% of cases.

First-choice therapy:

Excision with histological border control


Alternatively:

  • Curettage
  • X-ray soft beam technique (3-5 Gray, GD: max. 60 Gray, GHWT 1.0 mm)
  • Cryosurgery
  • Laser
  • Photodynamic Therapy

 

  • 5-fluorouracil ointment 5%
    • 1-2 x daily occlusive: Only on skin changes, not on healthy skin! Basaliomas should be treated until ulceration, other lesions until erosion!

 

  • Imiquimod cream: 5 times a week for 6 weeks
  1. Majores M, Bierhoff E. Aktinische Keratose, Morbus Bowen, Keratoakanthom und Plattenepithelkarzinom der Haut. Pathologe 2015;36:16-29.
  2. Majores M, Bierhoff E. [Actinic keratosis, Bowen's disease, keratoacanthoma and squamous cell carcinoma of the skin]. Pathologe 2015;36:16-29.
  3. Thestrup-Pedersen K, Ravnborg L, Reymann F. Morbus Bowen. A description of the disease in 617 patients. Acta Derm Venereol 1988;68:236-9.
  4. Grussendorf EI, Bar T. Condylomata acuminata associated with morbus Bowen (Carcinoma in situ). A light and electron microscopic study. Dermatologica 1977;155:50-8.
  5. Seyss R, Kopf O. [Roentgenotherapy of morbus Bowen and multiple carcinoids]. Krebsarzt 1952;7:15-8.