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Bowen Disease

(Bowen's Disease; Intraepidermal Squamous Cell Carcinoma)

By Gregory L. Wells, MD, Staff Dermatologist, Ada West Dermatology, St. Luke’s Boise Medical Center, and St. Alphonsus Regional Medical Center

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Bowen disease is a superficial squamous cell carcinoma in situ.

Bowen disease is most common in sun-exposed areas but may arise at any location.

Symptoms and Signs

Lesions can be solitary or multiple. They are red-brown and scaly or crusted, with little induration; they frequently resemble a localized thin plaque of psoriasis, dermatitis, or a dermatophyte infection.


  • Biopsy

Diagnosis is by biopsy, which shows full-thickness epidermal dysplasia but no dermal involvement.


  • Removal or ablation via local methods

Treatment depends on the lesion’s characteristics and may involve topical chemotherapy, curettage and electrodesiccation, surgical excision, or cryosurgery.


Because many skin cancers seem to be related to ultraviolet (UV) exposure, a number of measures are recommended to limit exposure.

  • Sun avoidance: Seeking shade, minimizing outdoor activities between 10 am and 4 pm (when sun's rays are strongest), and avoiding sunbathing and the use of tanning beds

  • Use of protective clothing: Long-sleeved shirts, pants, and broad-brimmed hats

  • Use of sunscreen: At least sun protection factor (SPF) 30 with broad-spectrum UVA/UVB protection, used as directed (ie, reapplied every 2 h and after swimming or sweating); should not be used to prolong sun exposure

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