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Bowen’s Disease

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Bowen’s Disease (intraepidermal squamous cell carcinoma) is a non-melanoma type of skin cancer affecting the outermost layer of the skin (the squamous cells). It is a very early form of cancer (pre-invasive) & is easy to treat. Sometimes it’s referred to as squamous cell carcinoma in situ.

It is not entirely clear what causes Bowen’s disease. There is a link with sun exposure, but this is not relevant in every case.
Bowen’s disease is easy to treat, & there are a variety of treatment options, including creams & topicals, cryotherapy, curettage, electrocautery, photodynamic therapy, laser treatment, & minor surgery. Treatment will depend on your preference & the severity of your individual case.

Definition

Bowen’s Disease (intraepidermal squamous cell carcinoma) is a non-melanoma type of skin cancer affecting the outermost layer of the skin (the squamous cells). It is a very early form of cancer (pre-invasive) & is easy to treat. Sometimes it’s referred to as squamous cell carcinoma in situ.

Symptoms

The main sign of Bowen’s disease is a patch or plaque of scaly, red skin that has clear, defined edges, & which doesn’t heal. There may be more than one patch or lesion, & they can occur simultaneously on different areas of the body. Bowen’s disease grows slowly, & the patches can become a few centimetres in diameter. They are most likely to occur on areas of the skin that have seen a lot of sun exposure, such as the head, hands, arms, trunk, lower legs, & neck, but it can appear on any part of the body, including the genitals (in which case it is associated with HPV, or human papillomavirus).
Frequently, the Bowen’s disease patch will not be associated with any other symptoms, which is why it may not be detected until the patient has a routine skin examination.
Characteristics of the Bowen’s disease patch are:
Red, pink, or brownish in colour
Darkly pigmented (less common)
Dry, crusty, or scaly surface
Flat or raised
Up to a few centimetres in diameter, but may be much smaller
May or may not be itchy
May or may not bleed or ooze pus
Tender or sore to touch
Those who have Bowen’s disease are at risk of developing skin cancer. If the patch becomes lumpy, bleeds or develops into an ulcer (an open sore) or nodule, this can indicate a more invasive form of squamous cell carcinoma (skin cancer). If the patch hardens (induration), this can indicate that it has become malignant. The risk of this malignancy is higher in patients who have a compromised immune system due to an existing condition or medication.
The symptoms of Bowen’s disease may resemble those of other skin conditions such as psoriasis, eczema (dermatitis), superficial basal cell carcinoma, actinic keratosis, seborrheic keratosis, or tinea corporis.

Step By Step

Step 1

Consultation

The dermatologist will examine your physical signs & ask you about any other symptoms you are experiencing. In some cases, a biopsy will be required, which is frequent with Bowen’s disease at it looks similar to other skin conditions.
 
Step 2

Procedure

If you do have a biopsy, this is a fairly straightforward, minor surgical procedure which may be done under local anaesthetic. You may not need any testing, however.
 
Step 3

After The Treatment

The dermatologist will advise you of the next steps, whether you require aftercare, a follow-up appointment, or a second appointment to carry out any necessary treatment procedures such as cryotherapy.