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Bowens Disease treatments have varying success rates

by admin on June 24, 2011

What Is Bowen’s Disease?

Bowens Disease is an early form of squamous cell carcinoma skin cancer, also known as in-situ squamous cell carcinoma or intraepidermal carcinoma. It arises in skin that had been damaged by the sun and therefore appears on sun exposed surfaces. If left untreated it can cover a large surface of the skin and can become invasive. It is more common in people over 60 years and is very uncommon under the age of 30.

What Does It Look Like?

Bowens Disease presents as dry scaly plates of skin gradually increasing in size. It may also be pink, it may itch and it may bleed.

How Do You Treat It?

It is a cancer and should be treated with respect. My preferred treatment option is with PDT using methyl aminolevulinate, better known as Metvix. This is reliable and effective with high cure rates. It does not require much patient effort for a successful outcome. It general involves treatment over two days, two to three weeks apart. On each day there are two visits, one in the morning for the application of cream with aluminium foil to prevent light exposure and a visit later in the day to activate the Metvix that has been absorbed by the skin. We control pain by administering paracetamol and ibuprofen and hour before light activation and using refrigerated air on the treated area. The treated are is red and swollen for four to five days, we supply a cleanser and a cream to apply regularly until the redness subsides.

Other treatments

Typically Bowen’s Disease is treated by most doctors with cryotherapy; that is with liquid nitrogen. The response to this treatment is not reliable and there is frequently recurrence associated with scarring from the freezing. Another treatment commonly used is with 5-fluorouracil also known as Efudix. This treatment has a low response rate, around 34%, even when used correctly. It often causes severe redness, ulceration and bleeding and since the treatment needs to extend over a number of weeks compliance with is often poor. Another treatment option is imiquimod, also known as Aldara.

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