Bowen’s disease: Causes, Symptoms, Diagnosis, Treatment, Prognosis and Prevention

The onset of the disease is more common in patients older than 50 years and patients with various comorbidities such as diabetics.

Bowen’s disease is a skin condition with red scaly patches of slow and continuous development. It is also known as squamous cell carcinoma in situ or SCC in situ and is a non-invasive and persistent form of intraepidermal carcinoma.

However, you have only a 10% chance of developing SCC, a common type of skin cancer. This condition, discovered in 1912, is named after a dermatologist, John Templeton Bowen.

Some young people have also been diagnosed with this disease. For the most part, women are more affected by this disease than men.

Causes and risk factors

Although the specific cause of Bowen’s disease is unknown, it is expected that certain risk factors contribute to the development of this condition. Having a weak immune system, for example, in people taking medications after an organ transplant or in people with AIDS.

People with fair skin, those who work outdoors and are exposed to the sun, and those who undergo treatment for immune disorders and generally take drugs are at high risk of developing this disease.

People with HPV infection (human papillomavirus) can also develop Bowen’s disease. An earlier injury to the skin that has scar tissue can also lead to the development of this condition, particularly in that area.


In rare cases, people with skin inflammation such as eczema may also develop Bowen’s disease. Bowen’s condition is not hereditary and can not be transmitted to others.

Signs and symptoms of Bowen’s disease

In general, Bowen’s disease occurs as a red, scaly patch on body locations exposed to direct ultraviolet radiation that emerges from the sun. The patch can be:

  • Red or pink
  • Scaly or crunchy
  • Flat or raised.
  • Up to a few centimeters wide.
  • It can even cause itching.

The edges of each point are different from normal skin and have an irregular shape. This disease has no symptoms and, therefore, could be neglected. Although it affects any part of the body, Bowen’s disease occurs mainly in the lower part of the leg.

In some cases, the spots can irritate, while they can hurt and begin to bleed in others.


This disease is often confused with other skin diseases such as psoriasis and eczema due to overlapping side effects, such as itching, skin, and scaly skin formation.

Bowen’s disease is often overlooked because it is asymptomatic. In general, it can be diagnosed through a regular skin exam. Consult your GP if you have a persistent red and scaly patch and do not know the cause.

It is essential to obtain an adequate diagnosis since Bowen’s disease can be seen as other conditions, such as psoriasis or eczema.

If necessary, your doctor will refer you to a skin specialist (dermatologist) to determine the problem. If you are not sure of the cause, you may need to remove a small skin sample so it can be examined more closely (a biopsy).


Bowen’s disease can be cured with several treatment options, such as:

The dermatologist performs this surgery to eliminate injuries using extreme cold conditions. This treatment has a success rate of 90%.

Curettage: This treatment includes scraping skin lesions with the help of a curette. The cauterization is then performed to treat the base of the affected skin, in which the skin burns lightly with an electric current.

Photodynamic therapy: a special light is used to eliminate injuries.

Topical creams: some creams are also used to destroy the cells of skin lesions.

Surgery: The general procedure includes cutting the lesions and suturing the skin. This treatment has a success rate of 100%, but with the disadvantage of leaving a scar.

Radiotherapy: this technique is not widely used since the healing process is complicated.


There are multiple treatment procedures for Bowen’s disease; however, recurrence is approximately one in ten. Therefore, a routine follow-up is required to verify if there are signs of reappearance.

Additional treatment may be suggested if this recurrence occurs. The prognosis of people with Bowen’s skin condition is generally reasonable. Most people who receive treatment and recover entirely from Bowen’s disease have no chance of developing skin cancer.

Prevention of Bowen’s disease

The fundamental risk factor for the development of Bowen’s disease is exposure to solar rales; it is essential to reduce exposure during the summer or days with plenty of suns, to prevent this condition.

Some steps you can take to prevent Bowen’s disease are:

    • Stay in the shade or indoors as much as possible, from 11 am to 3 pm
    • Cover the skin with clothes and a hat with a wide wing every time in the sun.
    • The application of sunscreen lotions such as SPF (sun protection factor) 15 and SPF 30 has great protection against UV radiation.