Bowen's disease, also known as squamous cell carcinoma in situ, is an early form of squamous cell skin cancer. Red, scaly patches on the skin are the primary symptom of Bowen's disease, which affects the squamous cells in the skin's outer layer. Although the patch typically grows extremely slowly, if treatment is not received, there is some possibility that it might develop into a more dangerous form of skin cancer. Let us take a look at what is Bowen's disease, how to identify Bowen’s disease, and the treatment options available for patients.  

What is Bowen's Disease?

Bowen's disease is a very early form of skin cancer that affects the skin's outermost layer. Another name for Bowen's disease is "squamous cell carcinoma in situ". The cells that make up the epidermis are called squamous cells, and "in situ" refers to the cancer being contained inside its initial site. 

Generally speaking, Bowen's disease is not dangerous, and there are effective treatments that can completely cure it. 

However, you shouldn’t disregard the condition since there is a slim chance that it might spread and develop into a more dangerous type of skin cancer. The symptoms of this cancer are the formation of red, scaly patches on the skin. Usually, the patches appear on the areas where you could easily notice them, but in some cases, Bowen's disease can also develop in the genital regions.  

Bowen’s Disease Symptoms

The majority of people with Bowen's disease only have one lesion, and only 10 to 20 percent of individuals experience multiple lesions. Usually, the lesion appears on your head or neck and resembles a plaque, which might be nodular, flat, or slightly elevated. Among the symptoms are the absence of blood in the affected region, and occasional itching, but some individuals may have asymptomatic lesions. The size of the lesions ranges from a few millimeters to a few centimeters. 

Bowen’s Disease Causes

The precise etiology of Bowen's skin cancer is unknown, however, there are certain elements connected to the illness.  

1. Chronic ultraviolet (UV) radiation exposure

Extended periods of exposure to ultraviolet (UV) light are a significant cause of Bowen's illness because UV rays affect your skin's DNA over time. Common UV radiation sources are sunshine, tanning beds, and a few fluorescent and halogen lights.  

2. Human papillomavirus (HPV) infection

An infection with the human papillomavirus (HPV) is another possible cause of Bowen's illness.  

3. Compromised immune system

One gene that acts as a tumor suppressor is the p53 gene, however, it can mutate in certain conditions and cause a variety of cancers, including Bowen's skin cancer. A compromised immune system may cause a p53 mutation to occur more frequently. A weakened immune system can be caused by immunosuppressant medications, radiation treatment, and hereditary conditions. 

4. Chronic arsenic exposure

Arsenic, an element with no flavor or smell, is harmful to people. Bowen's disease can result from long-term exposure to arsenic, but it takes around ten years from the initial exposure to develop. Drinking water contaminated with arsenic is one way to become exposed to arsenic. However, being close to industrial regions, inhaling air contaminated with arsenic, and being near landfills or waste sites also lead to arsenic exposure.  

Diagnosis

It's not always possible to diagnose Bowen's disease simply by looking at your skin because many different skin disorders may have similar symptoms. It can be misdiagnosed as potentially fatal conditions like melanoma as well as benign conditions like rashes or eczema, both situations can be psychologically taxing. To diagnose the cancer, your doctor typically has to take a sample of your skin for cancer testing, called a skin biopsy. 

Bowen's Disease Treatment

Bowen's disease treatment options depend upon a number of circumstances, including the severity of the patches, the location of the lesion, your age, the number of lesions on your body, your general health, and the drugs you use. The available treatment options are: 

1. Topical chemotherapy

A medicinal cream is administered to your lesion during topical chemotherapy, and these creams function by eliminating the skin cancer cells. Imiquimod 5 percent or 5-fluorouracil creams are used for this purpose, and they might be taken in addition to conventional therapies for Bowen's illness.

2. Surgery 

For minor lesions, the most common Bowen's disease treatment is surgery. Your lesion and the little area of normal tissue surrounding it will be removed by a surgeon during the surgery. This therapy works really well, however, it will cause a small, permanent scar. 

3. Cryosurgery

Extreme cold is used in cryosurgery, also known as cryotherapy, to destroy aberrant skin cells. Usually, argon gas or liquid nitrogen is used for this process, and it is usually advised if you have a single lesion in a place that will heal easily.  

4. Grenz rays

For lesions on difficult-to-treat regions, such as your scalp, and the area surrounding your genitals, Grenz rays are frequently employed, however, it is one of the more costly forms of treatment.

5. Topical photodynamic therapy

A light-sensitizing substance is put on your lesion for three hours during photodynamic treatment, and then the damage is selectively eliminated by projecting a light onto the targeted location.

6. Radiotherapy

High radiation doses are used in radiotherapy to eradicate cancerous cells, and the usual radiotherapy techniques for Bowen's disease include external beam radiation and radioactive skin patches.

Bowen's Disease Prevention

Reducing a person's sun exposure can help lower their chance of developing Bowen's disease since UV rays are the main cause of this illness. You should avoid working in direct sunlight, wear helmets and other protective gear when working outside, and use sunscreen with a minimum sun protection factor (SPF) of 30. However, you should remember that Bowen's disease can still strike those without a history of sun exposure.

Final Remarks 

Bowen's disease is a type of early skin cancer that is completely curable with treatment. Prolonged sun exposure is the most prevalent cause, although immune system weakening, HPV infections, and arsenic exposure can all be factors. Treatments include cryosurgery, topical chemotherapy, radiation, and surgical excision that remove the abnormal skin cells in your body. Bowen's illness has a high percentage of recovery when treated early, and if you see any symptoms, visiting a doctor immediately is the best course of action.