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B - Dermatology > Bowen's Disease > Flashcards

Flashcards in Bowen's Disease Deck (34):
1

What is Bowen's disease also known as?

SCC in situ

2

What is Bowen's disease?

A neoplastic skin disease that can be considered as an early stage or intra-epidermal form of SCC

3

What is the risk of progression from Bowen's disease to SCC in typical cases?

Around 3%

4

What is Bowen's disease a malignancy of?

Keratinocytes in the epidermal layer

5

What are the risk factors for Bowen's disease?

- Sun damage
- Other irradiation damage
- Carcinogens
- HPV
- Immunosuppression
- Chronic skin injury or dermatoses

6

What other forms of radiation damage can increase risk of Bowen's disease?

- Radiotherapy
- Photochemotherapy
- Sunbeds

7

Give a carcinogen that can cause Bowen's disease?

Arsenic

8

How does Bowen's disease typically present?

A slow growing erythematous hyperkeratotic patch or plaque with an irregular border

9

What are the features of Bowen's disease?

- Erythematous
- Hyperkeratotic/scaling
- Plaque/patch
- Irregular border
- Well defined

10

What additional features may be present in Bowen's disease?

Crusting/erosion

11

How big generally is Bowen's disease?

A few cm

12

What is the size of the Bowen's disease proportional to?

The duration

13

What is the main symptom of Bowen's disease?

Bleeding of the lesion

14

Where is Bowen's disease most commonly found on the skin?

Sun exposed areas

15

How is Bowen's disease typically diagnosed?

Clinically with a dermatoscope

16

If there is doubt about Bowen's disease what is required for histological diagnosis?

Punch biopsy

17

What are the differentials for Bowen's disease?

- Discoid eczema
- Psoriasis
- Lichen planus
- Actinic keratosis
- Superficial BCC
- Malignant melanoma

18

What is the recurrence rate for all treatments for Bowen's disease?

5-10%

19

What influences the choice of treatment in Bowen's disease?

- Age of patient
- Number of lesions
- Size of lesions
- Location of the lesions

20

What are the treatment options for Bowen's disease?

- Topical treatments
- Cryotherapy
- Surgery
- Photodynamic therapy

21

What is usually the first line therapy for Bowen's disease?

Topical treatment with 5-FU cream

22

When is 5-FU cream useful in Bowen's disease?

For large lesions with a history of poor healing

23

What can improve the efficacy of 5-FU in Bowen's disease?

Preceding laser or cryotherapy

24

What is used in cryotherapy of skin lesions?

Liquid nitrogen

25

What are the advantages of cryotherapy in Bowen's disease?

- Simple
- Quick
- Effective

26

What are the different surgical techniques for treating Bowen's disease?

- Curettage with cautery
- Surgical excision
- Moh's microqurgery

27

What happens in curettage of Bowen's disease?

Abnormal skin is scraped off under local anaesthetic and additional tissue is destroyed with electrocautery

28

What excision margin is recommended in excisional surgery of Bowen's disease?

5mm

29

When is Moh's microsurgery useful in Bowen's disease?

For areas that require skin sparing e.g. fingers, nails and penis

30

What is photodynamic therapy for Bowen's disease?

Preparing by removing crust/scale and using a photosensitising cream. Lesion is then exposed to a light source which burns away the area

31

When is photodynamic therapy useful in treating Bowen's disease?

Treating large lesions

32

What are the advantages of photodynamic therapy for Bowen's disease?

Better tolerated and better cosmesis than cryotherapy

33

What is the disadvantage of photodynamic therapy in Bowen's disease?

May be painful

34

What is the main complication of Bowen's disease?

Progression to invasive SCC