BOWEN'S DISEASE

Bowen's disease (BD) represents squamous cell carcinoma in situ. (The term Bowenoid AK is used to represent a severe actinic keratosis and may be identical histologically to BD, but occurs in the sun-exposed skin and has solar elastosis.)

A number of studies have demonstrated a relatively high incidence of human papillomavirus (e.g., HPV-16) in BD affecting the genital region and to a lesser extent elsewhere.

A slowly enlarging, sharply demarcated, red, scaly plaque is characteristic of BD. The most common site is unclear. In one study it was the head and neck and in another, the legs. Arsenic exposure predisposes to these lesions. Many patients have a prior history of either basal cell carcinoma or squamous cell carcinoma. Many lesions have irregular contours and one histologic study provided evidence that partial spontaneous regression may be the mechanism for central clearing and other irregular features. Occasionally, it may occur in the groin or perianal area or affect the nail unit. Rarely, BD may be pigmented (see below).

Pigmented Bowen's Disease

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