Bowen's disease: Two case reports of a giant and dwarf lesions

Abstract

Bowen's disease is a form of intraepidermal squamous cell carcinoma (SCC). It usually presents as a well-demarcated, slow growing erythematous patch, or plaque with a scaly or crusted surface. The size of the tumor varies from a few millimeters to several centimeters. The risk of progression into an invasive carcinoma is 3-5% in extragenital lesions and about 10% in genital lesions. We present two cases of Bowen's disease where the pattern, size, and perception of the disease between the patients varied. The two cases demonstrated two varying spectrum of the disease, one being a giant lesion and other a dwarf. One patient was more concerned about the lesion, whereas the other patient neglected the lesions, though widespread. High index of suspicion is required to diagnose such atypical presentations of Bowen's disease. As Bowen's disease has tendency to progress to SCC, it should be diagnosed and treated as early as possible.

Crusted plaque on pretibial area in an adult male

“…First described by John Bowen in 1912, Bowen's disease is a type of squamous cell carcinoma in situ , although a small proportion of cases can show invasive growth. [ 1 ] Several etiological factors of Bowen's disease have been reported, such as chronic sun exposure, arsenic exposure, immunosuppression, human papilloma virus, ionizing radiation, among others. It occurs usually in adults and commonly presents as a well-defined, erythematous, scaly or crusted plaque varying in size from a few millimetres to several centimetres.…”