Bowen's disease is a type of skin carcinoma in situ, primarily affecting patients over 40 years old, with a higher incidence in males than females. Prolonged sun exposure may be a significant contributing factor, and some cases are associated with arsenic exposure. Other potential triggers include long-term contact with coal tar, viral infections, friction, or injury. Early diagnosis and timely surgical excision are crucial for treatment.

bubble_chart Clinical Manifestations

1. The skin lesion is solitary or multiple, initially presenting as a red papule, gradually enlarging or coalescing into an irregular, slightly raised patch with scales or crusts on the surface;
2. Forcibly removing the crust reveals a granular or papillary moist surface, which may ulcerate;
3. The lesions commonly occur on the trunk, limbs, or face. Lesions on the glans penis, vulva, anus, or oral cavity are termed erythroplasia;
4. Approximately 10% of patients may progress to squamous cell carcinoma or develop visceral tumors, with a minority experiencing regional lymph node metastasis.

bubble_chart Diagnosis

1. After the age of 40, the course of skin lesions with the aforementioned changes in sun-exposed or non-exposed areas is chronic and progresses slowly;
2. There is a possibility of exposure to arsenic-containing substances in living or working environments;
3. Histopathology: Disordered arrangement of epidermal cells with atypical morphology, presence of tumor giant cells, abnormal divisions, and individual dyskeratotic cells.

bubble_chart Treatment Measures

Treatment Principles

1. Surgical treatment is the first choice (Mohs surgery yields the best results);
2. For small lesions, cryotherapy may be used;
3. For patients and areas unsuitable for surgical treatment, superficial X-ray therapy can be performed;
4. Topical chemotherapy is suitable for elderly patients or areas where surgery is not feasible, commonly using 5% 5-fluorouracil ointment for external application.

This condition is a carcinoma in situ of the skin, and surgical treatment should be prioritized. The use of 5-fluorouracil externally is only suitable for elderly patients or those who cannot undergo surgery or other physical treatments.

bubble_chart Cure Criteria

1. Cured: After treatment, the tumor completely disappears with no complications or recurrence;
2. Improved: After treatment, the tumor is mostly gone, requiring continued observation and follow-up;
3. Not cured: The tumor does not disappear after treatment, or there are significant complications.