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Merck Manual
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The trusted provider of medical information since 1899
Medical Topics & Chapters
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B
C
D
E
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G
H
I
J
K
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Professional /
Dermatologic Disorders /
Cancers of the Skin /
... /
Bowen Disease /
IN THIS TOPIC

Symptoms and Signs

Diagnosis

Treatment

Prevention

OTHER TOPICS IN THIS CHAPTER

Cancers of the Skin
Overview of Skin Cancer
Atypical Fibroxanthoma
Basal Cell Carcinoma
Bowen Disease
Kaposi Sarcoma
Keratoacanthoma
Melanoma
Merkel Cell Carcinoma
Paget Disease of the Nipple
Squamous Cell Carcinoma

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Rosacea
A 35-year-old woman comes to the office because she has had redness and swelling of her face for the past week. She says that she also has had several episodes of flushing and stinging in the same area after being outside in the cold during the same timeframe. Physical examination shows erythema, edema, and multiple telangiectasias on the cheeks and nose. This patient is most likely at which of the following phases of rosacea? 

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Bowen Disease

(Bowen's Disease; Intraepidermal Squamous Cell Carcinoma)

By

Gregory L. Wells

, MD, Ada West Dermatology, St. Luke’s Boise Medical Center, and St. Alphonsus Regional Medical Center

Last full review/revision Mar 2019| Content last modified Mar 2019
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Topic Resources

Bowen disease is a superficial squamous cell carcinoma in situ.

(See also Overview of Skin Cancer.)

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.

Diagnosis

  • Biopsy

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

Treatment

  • 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

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

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© 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA)
Basal Cell Carcinoma
Kaposi Sarcoma
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