Bowen’s Disease: Symptoms, Causes, Treatment

In Bowen disease (synonyms: Bowen-Darier disease; Bowen-Darier syndrome; Bowen dermatosis; Bowen dermatosis, Bowenoid precancerosis, dermatosis praecancerosa Bowen, Bowen carcinoma; Bowen epithelioma; Bowen disease; erythroplasia Queyrat; ICD-10-GM D04.-:Carcinoma in situ of the skin) is an in situ squamous cell carcinoma of the skin and transitional mucous membranes.

It is referred to as intraepidermal carcinoma in situ and is considered a precursor to squamous cell carcinoma (PEK; spinocellular carcinoma; formerly spinalioma, prickle cell carcinoma). Histologically, Bowen’s disease is an intradermal carcinoma. It can progress to an invasive, then usually bowenoid differentiated (pleomorphic poorly differentiated) PEK (Bowen’s carcinoma).

If this precancerous lesion is located in the mucosal area, it is referred to as erythroplasia queyrate.

The skin type does not play a role.

Sex ratio: Men are slightly more frequently affected than women.

Frequency peak: The disease occurs predominantly from the age of 40.

Course and prognosis: A spontaneous regression of Bowen’s disease does not occur. The course is always chronic, requiring complete surgical removal of the focus. In the long term, Bowen’s disease progresses to invasive squamous cell carcinoma (Bowen’s carcinoma, in about 30-50% of affected individuals). Bowen’s carcinoma may metastasize to the lymphatics (formation of daughter tumors). Later on, distant metastasis (the spread of tumor cells from the site of origin via the blood/lymphatic system to a distant site in the body and the growth of new tumor tissue there) is also possible. In approximately one-third of cases, erythroplasia queyrat results in progression (progression) to invasive spinocellular carcinoma (squamous cell carcinoma). In squamous cell carcinoma of the skin, metastasis occurs in only about 5% of tumor carriers. The 5-year survival rate for metastasis is 25-50%.