Bowen’s Disease (SCCIS)

Figure 5.7
A: Bowen’s disease*
B: SCC arising within DLE*
C: SCC, lip
* Courtesy of Dr. Paul Getz

(Figure 5.7A)

Squamous cell carcinoma in situ commonly presenting as a well-demarcated erythematous patch or plaque often in sun-exposed sites or mucous membrane; can also appear in sun-protected sites presenting as a pigmented plaque (often in dark-skinned patients); predilection for lower limbs in women and ear/scalp in men
Histology: full-thickness dysplasia of squamous epithelium with disorderly maturation of epidermis (loss of polarity, cytologic atypia, overall “wind-blown” appearance), overlying parakeratosis, loss of granular layer, possible stromal inflammation
Variants include atrophic, verrucous, pigmented and pagetoid variants, erythroplasia of Queyrat (on glans penis)
Treatment: surgical excision, electrodessication and curettage, photodynamic therapy (PDT), cryosurgery, topical imiquimod