Guidelines for management of Bowen's disease: 2006 update

Abstract

This article represents a planned regular updating of the previous British Association of Dermatologists (BAD) guidelines for management of Bowen's disease. They have been prepared for dermatologists on behalf of the BAD. They present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines.

BritishAssociation ofDermatologists' guidelines for the management of squamous cell carcinomain situ(Bowen's disease) 2014

“…2 It represents a planned regular update of the previous BAD guidelines for the management of SCC in situ (Bowen's disease). 3,4 Recommendations were developed for implementation in the U.K. National Health Service (NHS) using a process of considered judgement based on the evidence. The PubMed, Medline and Embase databases were searched for meta-analyses, randomized controlled trials (RCTs) and non-RCTs, case series, case reports and open studies involving SCC in situ (Bowen's disease) to September 2013; search terms and strategies are detailed in the Supporting Information.…”

“…4,74 PDT may be particularly appropriate for large lesions (> 3 cm diameter), with two treatments of MAL-PDT, 1 week apart, clearing 96% (22/23) of lesions at 3 months, with sustained clearance after three recurrences of 83% at 1 year. 75 Body site does not appear to impact the efficacy of PDT, with protoporphyrin IX accumulation identical in SCC in situ located on acral and nonacral sites.…”

Photodynamic Therapy and Skin Cancer

“…Therapy guidelines recommend PDT as the treatment of choice for both large and small plaques of BD on poor-healing sites, representing the majority of lesions and a good choice for large lesions in good-healing sites [105]. However, larger studies with longer follow-up are needed to better assess response rates.…”

Bowen’s Disease in Kashmir - A Pilot Study

“…But BD is also seen in subungual or periungual, palmar, genital and perianal areas. Usually BD is a solitary lesion, but in 10% to 20% of cases, it occurs at multiple sites 1,2 . 3% to 5% of extragenital lesions and about 10% of genital lesions may progress into an invasive carcinoma 3,4 .…”

“…In the Caucasian population, BD is quite commonly seen, with an incidence of 1.42 per 1000 in some populations 5 . Several etiological factors of BD have been reported, such as irradiation (ultraviolet irradiation, radiotherapy, photochemotherapy), carcinogens (eg, arsenic), immunosuppression (eg, after organ transplantation, AIDS), viral (strong association of perianal and genital lesions with HPV; 47% of acral and 24% of nonacral extragenital BD contain HPV genome) and some others like chronic injury or dermatoses 2,6 . There are various surgical and non-surgical treatment modalities for BD.…”