$Unique_ID{BRK03536} $Pretitle{} $Title{Bowen's Disease} $Subject{Bowen's Disease Intraepidermal Squamous cell Carcinoma Precancerous Dermatosis Psoriasis Paget's Disease of the Breast Malignant Melanoma} $Volume{} $Log{} Copyright (C) 1989 National Organization for Rare Disorders, Inc. 608: Bowen's Disease ** IMPORTANT ** It is possible that the main title of the article (Bowen's Disease) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Intraepidermal Squamous cell Carcinoma Precancerous Dermatosis Information on the following diseases can be found in the Related Disorders section of this report: Psoriasis Paget's Disease of the Breast Malignant Melanoma General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Bowen's Disease is characterized by a precancerous, slow growing skin malignancy. The major symptom is a red-brown, scaly or crusted patch on the skin which resembles psoriasis or dermatitis. It may occur on any part of the skin or in the mucous membranes. Symptoms The first sign of Bowen's Disease is a plaque located on or within the skin (intraepidermal). It is a scaly area which may be recognized as squamous cell carcinoma in the initial stage of development. Pinkish or brownish raised areas of skin (papules) appear. They are usually irregular in shape and covered with a light crusty covering which, when removed, shows an oozing red surface. Bowen's Disease may be confused with common skin disorders as psoriasis or other similar types of dermatitis. It is slow growing and responds well to immediate treatment, but if left untreated Bowen's Disease can result in skin cancer and eventually spread to other parts of the body. Causes The exact cause of Bowen's Disease is not known. Like many forms of skin cancer, chronic sun exposure may cause it to develop. Ingestion of arsenic can be associated with the occurrence of the disease in skin ares unexposed to light, or in the mucous membranes. Human papillomavirus 16 DNA is found repeatedly in Bowen's Disease lesions, suggesting that a slow virus is also a possible cause. (Slow viruses may stay dormant in humans for extended periods of time, then for reasons yet unknown, may unexplainably become reactivated. The role of heredity which may make a person susceptible to slow viruses is not well understood). In other cases, no cause can be determined. Affected Population Bowen's Disease affects both males and females. However, when found in the genital area, women are affected three times as often as men. The disease may occur at any age but is very rare in children. Related Disorders Symptoms of the following disorders can be similar to those of Bowen's Disease. Comparisons may be useful for a differential diagnosis: Psoriasis is a common chronic and recurrent skin disorder characterized by dry, well-circumscribed silvery gray scaling spots or plaques which usually appear on the scalp, elbows, or knees. Symptoms may begin gradually. Psoriasis characteristically involves the scalp, extremities, the back and buttocks with sharply outlined lesions consisting of red spots or plaques covered with scales that usually do not itch. These lesions may heal without scarring and hair growth near the plaques is not affected. In severe cases, Psoriasis lesions may appear in pustular form. General health usually is not affected, unless severe arthritis (psoriatic arthritis) or untreatable scaling develops. However, stress may be caused by the stigma of an unsightly skin disorder. (For more information on these disorders, choose "Psoriasis" as your search term in the Rare Disease Database). Paget's Disease of the Breast (which is not related to Paget's Disease of bone) is characterized by cancer of the nipples of the breast. It can occur in both men and women. The major symptoms include an oozy, crusty skin inflammation (dermatitis) of the nipple which is nearly always associated with glandular (adenocarcinoma) cancer of the breast. A form of Paget's Disease of the Breast also affects the genital area, primarily in women. This condition responds well to treatment when it occurs on the surface of the skin. In cases associated with carcinoma of the rectum, treatment may be more difficult. Malignant Melanoma is a common form of skin cancer. It is marked by tumors of the pigmentation cells (melanocyte) of the skin. These tumors may appear in different sizes, shapes, and shades of color, and may spread to adjacent parts of the body. Tumors may also spread through the blood and lymph circulation to other organs. Early treatment of malignant Melanoma is essential in order to cure the disease. Therapies: Standard Treatment of Bowen's Disease usually involves surgical removal of the malignancy. Carbon dioxide lasers are the most effective method of removing surface skin lesions. Other types of growths require different types of surgery. Other treatment is symptomatic and supportive. Therapies: Investigational This disease entry is based upon medical information available through April 1989. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on this disorder, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 The Skin Cancer Foundation 475 Park Avenue, South New York, NY 10016 (212) 725-5176 American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329 (404) 320-3333 NIH/National Cancer Institute 9000 Rockville Pike, Bldg. 31, Rm. 1A2A Bethesda, MD 20892 1-800-4-CANCER The National Cancer Institute has developed PDQ (Physician Data Query), a computerized database designed to give the public, cancer patients and families, and health professionals quick and easy access to many types of information vital to patients with this and many other types of cancer. To gain access to this service, call: Cancer Information Service (CIS) 1-800-4-CANCER In Washington, DC and suburbs in Maryland and Virginia, 636-5700 In Alaska, 1-800-638-6070 In Oahu, Hawaii, (808) 524-1234 (Neighbor islands call collect) The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse Box AMS Bethesda, MD 20892 (301) 495-4484 References INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 1114, 1373, 1389. BOWEN'S DISEASE OF THE FEET. PRESENCE OF HUMAN PAPILLOMAVIRUS 16 DNA IN TUMOR TISSUE. M.S. Stone, et al.; Arch Dermatol (November, 1987, issue 123 (11)). Pp. 1517-1520. BOWEN'S DISEASE AND INTERNAL MALIGNANT DISEASES. A STUDY OF 581 PATIENTS. F. Reymann, et al.; Arch Dermatol (May, 1988, issue 124 (5)). Pp. 677-679. BOWENOID PAPULOSIS IN A THREE-YEAR-OLD GIRL. C. Halsz, et al.; J Am Acad Dermatol (February, 1986, issue 14 (2 Pt 2)). Pp. 326-330.