Merck Manual

Please confirm that you are a health care professional

honeypot link

Bowen Disease

(Bowen's Disease; Intraepidermal Squamous Cell Carcinoma)


Gregory L. Wells

, MD, Ada West Dermatology and Dermatopathology

Reviewed/Revised Sep 2022
Topic Resources

Bowen disease is a superficial squamous cell carcinoma in situ. Diagnosis is by biopsy. Treatment depends on the tumor’s characteristics and may involve curettage and electrodesiccation, surgical excision, topical chemotherapy, electrocautery, or cryosurgery.

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

Symptoms and Signs of Bowen Disease

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 or dermatitis or a dermatophyte infection.

Diagnosis of Bowen Disease

  • Biopsy

Bowen disease is often suspected when a rash secondary to a disorder such as psoriasis or atopic dermatitis fails to respond to treatment.

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

Treatment of Bowen Disease

  • Removal or ablation via local methods

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

Prevention of Bowen Disease

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 hours and after swimming or sweating); should not be used to prolong sun exposure

NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
quiz link

Test your knowledge

Take a Quiz!