Bowen’s Disease

Bowen’s disease commonly appears as a persistent patch of scaly, crusty or rough skin with a clearly defined edge. On lighter skin it may appear red or pink, although changes in colour can be less noticeable on brown or black skin.

The patch may be flat or slightly raised and can sometimes itch. Because Bowen’s disease can resemble eczema, psoriasis and other skin conditions, a persistent or changing patch should be professionally assessed.

Yes. Bowen’s disease is also known as squamous cell carcinoma in situ (SCC in situ). This means abnormal cancerous squamous cells are present but remain confined to the outermost layer of the skin and have not invaded the deeper tissues.

Bowen’s disease is usually slow-growing and can often be treated effectively. However, it should not be ignored because a small proportion of untreated cases can progress to invasive squamous cell carcinoma.

Appropriate assessment allows a dermatologist to confirm the diagnosis and determine whether treatment or monitoring is required.

Yes. Bowen’s disease is an early, non-invasive form of squamous cell carcinoma. In a small proportion of cases, the abnormal cells can grow into deeper layers of the skin and become invasive squamous cell carcinoma.

Changes such as the development of a lump, ulceration or bleeding within an existing patch should be medically assessed.

Long-term exposure to ultraviolet (UV) radiation from sunlight is an important risk factor for Bowen’s disease, which is why it commonly occurs on sun-exposed skin.

Other recognised risk factors include a weakened immune system, previous radiotherapy and, in some cases, infection with certain types of human papillomavirus (HPV).

Bowen’s disease can develop anywhere on the skin but is frequently found on areas that have received significant sun exposure, including the head, neck and lower legs.

It can also occur on areas that are not routinely exposed to the sun.

A dermatologist will usually begin by examining the affected area. Because Bowen’s disease can resemble several other skin conditions, a biopsy may be recommended to confirm the diagnosis.

This involves removing a small sample of the affected skin so that the cells can be examined under a microscope.

Treatment depends on factors including the size, location and number of lesions, as well as the patient’s overall health.

Options can include topical medication, cryotherapy, curettage and cautery, photodynamic therapy or surgical removal. In selected cases, careful monitoring may be appropriate.

Your dermatologist will discuss which approach is most suitable for you.

Not always. Surgery is one treatment option for Bowen’s disease, but other treatments may be appropriate depending on the characteristics and location of the lesion.

Your dermatologist will assess the affected area and explain the advantages and limitations of the treatment options available to you.

Bowen’s disease can occasionally recur after treatment. People who develop Bowen’s disease may also have significant previous sun exposure and can develop other areas of sun damage or skin cancer.

Follow-up, monitoring your skin for changes and protecting it from excessive UV exposure are therefore important.

You should consider having a persistent skin change assessed if you notice a scaly, crusty or red patch that does not heal, particularly if it continues to grow or change.

A patch that begins to bleed, ulcerate or develop a lump should be assessed promptly, as these changes can sometimes indicate progression to invasive squamous cell carcinoma.

Bowen’s disease is squamous cell carcinoma in situ, meaning the abnormal cells remain confined to the epidermis and have not invaded deeper tissues.

In invasive squamous cell carcinoma, the cancerous cells have grown beyond the epidermis into deeper layers of the skin. This distinction is important because invasive SCC has the potential to spread to other parts of the body.

At our Wrexham clinic, we provide dermatologist-led assessment and management of suspected Bowen’s disease.

Dr Keli Thorsteinsson, Dr James Dean and Dr Richard Jerrom can assess persistent or suspicious skin lesions, arrange further investigation where required and recommend an appropriate treatment plan based on your diagnosis.

Where clinically appropriate, skin surgery can also be discussed as part of your treatment.

At our Nantwich clinic,  Dr James Dean. provides specialist dermatology assessment for suspicious or persistent skin lesions, including possible Bowen’s disease.

Following examination, he can advise whether further investigation, such as a biopsy, is appropriate and discuss the treatment options available if Bowen’s disease is diagnosed.

Freyja Medical provides specialist dermatology assessment for Bowen’s disease and other suspicious skin lesions in Chester.

Dr James Dean can carefully examine the affected area, assess whether Bowen’s disease or another skin condition may be responsible and advise on any further investigation or treatment required.

At our Shrewsbury clinic, Dr Keli Thorsteinsson provides consultant dermatologist-led assessment of persistent and suspicious skin lesions, including possible Bowen’s disease.

Following examination, he can advise whether further investigation is required and develop an individual management plan if Bowen’s disease is diagnosed.