Medically reviewed by Dr. A.M. van Coevorden, dermatologist
Bowen's diseasean early, superficial form of skin cancer
Bowen's disease, also called morbus Bowen, is an early, superficial form of skin cancer in which the malignant cells are only in the top layer of the skin. Left untreated, it can develop into a squamous cell carcinoma, which grows deeper and can spread. To prevent this, Bowen's disease is always treated.
What is Bowen's disease?
Bowen's disease (also morbus Bowen) is an early, superficial form of skin cancer, in which the malignant skin cells are only in the top layer of the skin. Left untreated, it can develop into a squamous cell carcinoma, a form of skin cancer that grows deeper and can spread. To prevent this, patients with Bowen's disease are always treated.
How do you get Bowen's disease?
Bowen's disease mainly develops in older people. A lot of sun exposure is the main cause. You are also at higher risk if you take immune-suppressing medicines.
What symptoms does it cause?
Bowen's disease usually causes no symptoms, although a spot can sometimes itch or hurt. Usually there is one red, scaly patch that slowly grows. It can be confused with eczema or psoriasis but does not heal with treatment for those. It usually appears on sun-exposed skin but can also develop in the genital area or on mucous membranes.
Is it contagious?
No. Bowen's disease is not contagious.
How is the diagnosis made?
The doctor often suspects Bowen's disease from looking at the spot. The definitive diagnosis comes from a skin biopsy, in which a small piece of skin is removed under local anaesthetic. This is sometimes needed because many skin diseases resemble it, such as eczema, psoriasis and basal cell carcinoma.
What treatments are there?
Depending on your medicines, the size and the location, the doctor chooses a treatment with you.
Curettage and coagulation: scraping off with a sharp spoon and cauterising; can cause scars.
Freezing with liquid nitrogen: the spot is dabbed, forms a blister or crust and dies off; mainly for small spots, can cause discolouration or a scar.
Excision: cutting out under local anaesthetic, after which the tissue is examined under the microscope; if not fully gone, more is cut away.
Fluorouracil cream (Efudix, active ingredient 5-fluorouracil) damages fast-dividing diseased cells and spares the healthy ones, so the Bowen cells die off.
Photodynamic therapy: a cream makes the cells light-sensitive, after which illumination with a special lamp kills the cancer cells.
Can Bowen's disease be cured?
Yes, Bowen's disease can be cured. You can, however, get new spots.
What can you do yourself?
Keep a close eye on your skin. Make an appointment for spots that keep growing or will not heal. Protect your skin from the sun to prevent new spots.
Frequently asked questions about Bowen's disease
Is Bowen's disease skin cancer?
Yes, an early, superficial form in which the malignant cells are only in the top layer of the skin. Untreated, it can grow into a squamous cell carcinoma.
Why is it always treated?
To prevent it developing into a squamous cell carcinoma, which grows deeper and can spread.
How do I recognise it?
Usually as one red, scaly patch that slowly grows and does not heal with eczema or psoriasis cream. Have such a patch assessed.
What treatments are there?
Scraping and cauterising, freezing, cutting out, Efudix cream or photodynamic therapy, depending on the location and size.
Can it be cured?
Yes. You can get new spots later, so skin checks and sun protection remain important.