Originally described in 1912 by John T. Bowen, this is a form of skin cancer. Fondly known just as "Bowen's" by dermatologists, it is an intraepidermal form of squamous cell carcinoma.

Typical BD presents as a gradually enlarging, well demarcated erythematous plaque with an irregular border and surface crusting or scaling. Symptoms are minor in the absence of ulceration. BD may occur at any age in adults but is rare before the age of 30 years; most patients are aged over 60. Lesions are usually solitary but are multiple in 10-20% of patients. Any site may be affected, although involvement of palms or soles is uncommon. BD occurs predominantly in women (70-85% of cases), and about three-quarters of patients have lesions on the lower leg (60-85%).

Genital lesions which have the histology of BD include erythroplasia of Queyrat and Bowenoid papulosis. Erythroplasia of Queyrat (penile intraepithelial neoplasia) occurs on the glans penis and under the prepuce, virtually always in uncircumcised men. Comments on vulval BD in these guidelines are drawn from references written over several years, which may have included both lesions morphologically similar to BD at other body sites and other dysplastic lesions which would be classified as vulval intraepithelial neoplasia (VIN) according to current terminology.

Bowenoid papulosis is a different disorder with a viral aetiology, slight female predominance and benign behaviour in most cases, but it may cause extensive multiple lesions.

Causes of BD are solar damage, arsenic, immunosuppression (including AIDS), viral (human papillomavirus or HPV) and chronic skin injury and dermatoses.

Diagnosis is from clinical features with biopsy necessary only where there is diagnostic doubt or where malignant spread is suspected.

Suggested treatment of Bowen's is usually surgical excision of the lesion, although curettage, fluorouracil, cryotherapy and laser treatments have been described.

Bowen's disease also refers to carcinoma-in-situ of the penis or scrotum.

nice picture at http://www.meddean.luc.edu/lumen/MedEd/medicine/dermatology/melton/bowens1.htm

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