Bowen's disease

At CHEC, we understand the impact that Bowen’s disease can have on daily life. This dedicated page aims to provide you with essential information about Bowen’s disease.

Understanding Bowen’s disease

Bowen’s disease, also known as squamous cell carcinoma in situ, is a very early form of skin cancer where cancerous cells are confined to the outermost layer of the skin (the epidermis) and have not spread deeper into the tissue.

It typically appears as a:

Red patch: The affected area is usually pink or red.
Scaly or crusty surface: The patch often has a rough, flaky texture.
Irregular border: The edges of the patch may not be well-defined or smooth.
Slowly growing: The patch tends to enlarge gradually over months or years.
Flat or slightly raised: It can be level with the skin or have a subtle elevation.
Variable size: It can range from a few millimetres to several centimetres in diameter.
Sometimes itchy: While often asymptomatic, the patch can occasionally be itchy, sore, or bleed.

Bowen’s disease most commonly occurs on sun-exposed areas of the skin, such as the:

Lower legs (especially in women)
Head and neck
Hands
Scalp

Less frequently, it can appear:

In the genital area (where it may have different names like erythroplasia of Queyrat on the penis or vulval intraepithelial neoplasia (VIN) in women).

Under or around nails
On the palms or soles
Around the anus

When To Seek Help

Although Bowen’s disease itself is not typically life-threatening because the abnormal cells are contained within the epidermis, treatment is generally recommended and should be sought in the following situations:

New skin patch: If you notice a new red, scaly patch on your skin that doesn’t heal or go away within a few weeks, it’s important to get it checked by a doctor.

Changes in an existing patch: If an existing skin patch changes in size, shape, colour, or starts to bleed, crust, or become painful.

Uncertain diagnosis: Bowen’s disease can sometimes resemble other skin conditions like eczema, psoriasis, or ringworm. A healthcare professional can provide an accurate diagnosis.

Risk of progression: While the risk is low (around 3-5% in typical cases), Bowen’s disease can potentially develop into an invasive squamous cell carcinoma, a more serious form of skin cancer that can spread. Treating it early minimises this risk. The risk might be slightly higher for lesions in the genital area.

Symptomatic lesions: If the Bowen’s disease patch is itchy, sore, or causing discomfort. Cosmetic concerns: Depending on the location and size, the patch might be cosmetically bothersome.

Doctor’s recommendation: Your doctor or dermatologist will assess your specific situation and recommend treatment based on factors like the size, location, thickness of the lesion, your age, and overall health. In some cases where the lesion is very slow-growing and not causing any issues, especially in older individuals with other health concerns, the doctor might recommend monitoring instead of immediate treatment. However, any changes should prompt a review. It is crucial not to ignore a suspicious skin patch. Early diagnosis and treatment of Bowen’s disease have a very high cure rate.

NHS Treatment

CHEC’s commitment to delivering accessible dermatology services within community settings aims to reduce patient waiting times and improve access to essential care. By working in partnership with the NHS, we strive to provide a seamless pathway for individuals experiencing dermatitis, ensuring they receive the support and treatment they need to manage their condition effectively. Our goal is to enhance the quality of life for those living with Bowen’s disease, enabling them to regain comfort and confidence in their skin.

What to expect when visiting a CHEC Hospital:

Further Information

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