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At least 73 records · Page 4Linked to original sources
PubMed2003

Randomized comparison of photodynamic therapy with topical 5-fluorouracil in Bowen's disease.

BACKGROUND: Bowen's disease (BD; intraepithelial squamous cell carcinoma) is therapeutically challenging because lesions, which may be multiple, are frequently located at sites that heal poorly. There is a small risk of progression to invasive carcinoma. Photodynamic therapy (PDT) is an effective treatment for certain non melanoma skin cancers, but comparison studies with other, better-established therapies are limited. OBJECTIVES: To compare the efficacy and tolerability of PDT and topical 5-fluorouracil (5-FU) in BD. METHODS: Forty patients from two centres were randomized to either topical PDT or 5-FU. The PDT group was treated with 20% 5-aminolaevulinic acid (ALA) applied 4 h before illumination with 100 J cm-2 narrowband red light (630 +/- 15 nm). 5-FU was applied to lesions for 4 weeks. A repeat treatment cycle was performed after 6 weeks if required. Results Twenty-nine of 33 (88%) lesions treated with PDT initially responded completely, compared with 22 of 33 (67%) after 5-FU. After 12 months, two recurrences in the PDT group and six in the 5-FU group reduced complete clinical clearance rates to 82% and 48%, respectively. PDT was significantly more effective (P = 0.006, odds ratio 4.78, 95% confidence interval 1.56-14.62). In the 5-FU group, severe eczematous reactions developed around seven lesions, ulceration in three and erosions in two. No such reactions occurred following PDT. There was no difference in overall pain experienced during each therapy. CONCLUSIONS: Topical ALA-PDT is more effective than topical 5-FU in the treatment of BD, with fewer adverse events. ALA-PDT should be considered one of the first-line therapeutic options for BD.

Administration, Topical↗
PubMed2001

Overexpression of transforming growth factor-beta3 immunohistochemical staining in extramammary Paget's disease, but downregulated expression in Bowen's disease.

BACKGROUND: The role of transforming growth factor-beta (TGF-beta) in carcinogenesis is complex, with some reports indicating a tumor inhibition role and others indicating a tumor promotion role. In particular, TGF-beta3 is thought to play a key role in controlling epithelial homeostasis. Immunopositive p53 has been demonstrated in a variety of human malignant tumors and its role in oncogenesis and tumor progression is thought to be important. Extramammary Paget's disease (EPD) and Bowen's disease are skin cancers of unknown histogenesis. OBJECTIVE: To clarify the role of TGF-beta3 and p53 in EPD and Bowen's disease and to better understand the origin of these disorders. METHODS: Specimens were obtained from 12 patients with EPD and 12 patients with Bowen's disease seen at our clinic between 1993 and 2000. TGF-beta3 and p53 immunohistochemical staining was performed. RESULTS: In three of the 12 EPD patients and five of the 12 Bowen's disease patients, positive p53 staining was detected. In contrast, TGF-beta3 overexpression was detected in all EPD patients, whereas downregulated TGF-beta3 expression was detected in all Bowen's disease patients. CONCLUSIONS: The present data suggest different roles for TGF-beta3 in abnormal epidermal cells in EPD and Bowen's disease. Thus, TGF-beta3 expression may be modulated differently via a p53-dependent or -independent pathway in the pathogenesis of EPD and Bowen's disease. Moreover, high TGF-beta expression appears to be a useful indicator of tumor activity in EPD.

Aged↗
PubMed2001

Comparative histochemical study of Bowen's disease and actinic keratosis: preserved normal basal cells in Bowen's disease.

The degree of DNA-instability as revealed by immunohistochemical staining with anti-cytidine antibody after acid hydrolysis (DNA-instability test) has been recently used as a marker of malignancy. This technique was applied to examine 17 skin tissue samples of Bowen's disease, 47 of actinic keratosis, 15 of squamous cell carcinoma, 5 of seborrheic keratosis, and 10 of normal skin. All benign neoplastic cells of seborrheic keratosis and normal epidermal cells were negative. On the other hand, all cancer cells were positive with the DNA-instability test, indicating their malignancy, but all basal cells in Bowen's disease were completely negative. Compatible with this result, the basal cells in Bowen's disease were characteristically normal as evident in other histochemical examinations. Thus, they were negative with p53 immunohistochemistry, with normal signals of chromosome 17 in situ hybridisation and argyrophilic nucleolar organiser region, and showed slightly enhanced proliferative activity as revealed by proliferating cell nuclear antigen immunohistochemistry. Immunohistochemical staining with 34 beta E12 (monoclonal antibody against cytokeratins 1, 5, 10, and 14), which stains all normal epidermal keratinocytes including basal cells, showed that only the basal cells of Bowen's disease stained strongly and homogeneously, while all cancer cells in the upper layers of Bowen's disease and all layers of actinic keratosis were only sporadically or weakly stained. Staining with 34 beta B4 (monoclonal antibody against cytokeratin 1), which recognises the whole epidermis except for the basal layer in the normal epidermis, showed that the basal cells in the Bowen's disease were completely negative, and lower layer cells in the actinic keratosis and upper layer cells in Bowen's disease were only sporadically stained positive, although the superficial layer cells in actinic keratosis stained strongly and homogeneously. Our findings clearly indicate that the basal cells in Bowen's disease are normal. In support of this conclusion, the same cells showed normal morphology on electron microscopy with preserved basement membrane, although the latter was often damaged in actinic keratosis.

Actins↗
PubMed1988

Distribution of EGF receptor expressing and DNA replicating epidermal cells in psoriasis vulgaris and Bowen's disease.

We have examined the localization of DNA replicating cells and EGF receptor-expressing cells in the epidermis of psoriasis vulgaris, a benign hyperproliferative skin disease, and Bowen's disease, a pre-malignant hyperproliferative skin disease, and normal skin. DNA replicating cells were detected by anti-BrdU monoclonal antibody after incubating tissue sections with BrdU, and EGF receptors were detected by the anti-EGF receptor monoclonal antibody B4G7. In normal skin, DNA replicating cells were localized exclusively in the basal and suprabasal layers. EGF receptor expression was observed most strongly in the basal and parabasal layers, but diminished gradually towards the upper squamous layer. In psoriatic skin, DNA replicating cells were also localized in the basal and parabasal layers, but the number of these mitotic cells was about 10 times higher than in normal skin. In this case, more EGF receptors were detected in all viable layers of the epidermis. Apparently normal skin adjacent to psoriasis lesions showed persistent expression of EGF receptors in the upper squamous layer without an increased number of DNA replicating cells in the basal and parabasal layers. In Bowen's disease, DNA replicating cells and EGF receptor expressing cells were distributed in all layers of the epidermis. These findings indicate that the increased production of EGF receptors may be, in part, responsible for the hyperproliferative state of the epidermis and that cells in the upper squamous layer of psoriasis may have lost a mechanism by which EGF receptor expression is diminished thus allowing differentiation. This altered process of EGF receptor production may be involved in the onset of psoriasis vulgaris.

Adult↗
PubMed2003

Treatment of large facial Bowen's disease: case report.

Bowen's disease (BD; squamous cell carcinoma in situ) is a common, persistent condition that can be related to chronic sun damage, and consequently, is usually located around the head and neck area and lower limbs. Bowen's disease can be treated with a variety of methods, including surgery or laser therapy, but large lesions tend to scar postexcision and hence are difficult to treat surgically. Here we present the case of a 75-year-old woman with a 20-year history of facial BD unabated by treatment with a variety of topical agents and cryotherapy. Application of imiquimod 5% cream on alternate nights for 6 weeks resulted in total clearance with no recurrence observed after 8 months.

Administration, Topical↗
PubMed2005

Bowen's disease involving the urethra.

Bowen's disease developing on mucous or mucocutaneous regions is clinically called erythroplasia of Queyrat. We report herein a 56-year-old male with Bowen's disease extending from the penis shaft to the glans penis, and urethral meatus. Physical examination revealed bright red velvety plaques on the prepuce and glans penis and an irregularly pigmented scaly lesion on the dorsum of his penis shaft. Histopathological findings of both lesions were compatible with those of Bowen's disease, supporting the concept that erythroplasia of Queyrat and Bowen's disease should be regarded as one clinicopathologic entity. A partial penectomy was finally performed, because tumor cells were pathologically observed in the mucous epithelium of the urethra. Although several therapeutic modalities exist for Bowen's disease on the external genitalia, treatment options are limited when Bowen's disease extends to the urethral meatus. We discussed the recent therapeutic modalities in genital Bowen's disease.

Biopsy, Needle↗
PubMed1983

Bowen's disease of the palm.

Bowen's disease is a squamous cell carcinoma characterized by isolated, grouped or confluent nodules, either flat, scaling, or crusted, with an arcuate or serpiginous configuration. Malignant dyskeratosis throughout the epidermis, the bowenoid hallmark, is not sufficient by itself to identify a lesion as Bowen's disease. It has been suggested, but not proven, that arsenic has a role in the etiology of Bowen's disease. A case of Bowen's disease affecting the palm, an unusual location, is reported.

Aged↗
PubMed1994

Body site distribution of Bowen's disease.

Several studies of Bowen's disease suggest that most lesions occur on the head and neck, a finding which does not concur with observations in clinical practice in the U.K. In order to test the hypothesis that this reported distribution is due to an increased tendency of physicians to submit lesions of Bowen's disease occurring at these sites for histopathological examination, in comparison with lesions at other body sites, 52 cases of Bowen's disease identified from out-patient clinic diagnostic records were compared with 56 cases derived from pathology records. In both groups, the majority of lesions were on the lower leg; a greater number in the clinical cases group (45/52; 87%) than in the pathology cases (26/56;46%). The lower leg lesions were almost exclusively in women (96% of lower leg lesions occurred in women in each group). The pathology group contained more men (29%) than the clinical group (12%), and also more upper limb lesions (23% compared with 8% in the clinical group). There was no evidence that these differences were due to incorrect clinical diagnosis, and the likely explanation is that lesions diagnosed as Bowen's disease in men, or at sites other than the lower leg, are more likely to be biopsied than clinically typical lesions on the female lower leg. This type of bias is likely to affect larger series in which only biopsied cases are included, and may explain the discrepancy between observations reported in previous publications and the situation in routine clinical practice.

Aged↗
PubMed1987

[Bowen's disease of the anus].

Bowen's disease of the anus and the perineum is undoubtedly a rare pathology. This is demonstrated by the fact that, while described by M. Bowen in 1912, only 112 cases have been reported in 1979. The differential diagnosis is more difficult than that of Bowen-like papulosis and Queyrat's erythroplasia. Ano-perineal Bowen's disease is, or may be, in a large number of cases, seen concomitantly with a primary ano-rectal or vaginal carcinoma, even if they were diagnosed after Bowen's disease.

Anus Neoplasms↗
PubMed1991

Argon laser therapy for perianal Bowen's disease: a case report.

Bowen's disease (intraepithelial squamous cell carcinoma) may occasionally occur in anal canal or perianal region. Surgical excision in this area may result in significant complications and a recurrence rate of 9-19%. A case of successful treatment of anal and perianal Bowen's disease using argon laser therapy is presented. No acute or chronic complications resulted from laser therapy. Twenty-eight months after the initial diagnosis the patient is disease free. Laser therapy also provides the potential for repeated treatment of recurrent lesions without significant patient discomfort or inconvenience. Argon laser therapy should be considered as a therapeutic option in the treatment of Bowen's disease.

Anus Neoplasms↗
PubMed2005

[Perianal Bowen's disease treated with imiquimod].

Bowen's disease is a special form of squamous cell carcinoma in situ that usually develops in photoexposed areas of skin. The treatment of choice is surgery. Less frequently, it may appear in other locations such as the nails, glans penis, intertriginous areas and the perianal region, where conventional treatment may be complicated. We contribute a new case of perianal Bowen's disease, which responded to treatment with imiquimod with no evidence of clinical recurrence after 3 years of follow up. Imiquimod appears to be a therapeutic alternative for perianal Bowen's disease, which seems to have a particular tendency to recur in this location where surgery may also be complicated.

Aged↗
PubMed1999

Detection of human papilloma virus type 56 in extragenital Bowen's disease.

A case of Bowen's disease arising on the medial part of the first metatarsal bone of an 81-year-old Japanese woman is described. Histopathologically, proliferation of atypical cells was found throughout the epidermis. Electronmicroscopy revealed virus particles 40-50 nm in diameter in the nuclei of tumour cells at the granular cells just on or below the horny layer. Positive bands were obtained by polymerase chain reaction using a consensus primer of human papilloma virus L1 portion. Sequencing analysis of the amplified DNA revealed the same base sequences and homology as human papilloma virus 56. To the best of our knowledge, this case is the first report in which human papilloma virus 56 was found in a case of extragenital Bowen's disease. We consider it important to understand that human papilloma virus 56, often found in cervical lesions, can be detected in extragenital Bowen's diseases.

Aged↗
PubMed1989

Conservative management of Bowen's disease of the anus.

Bowen's disease of the anus is usually treated by wide local excision including macroscopic normal areas if random biopsies show dysplasia. Skin grafting will often be necessary, since areas of microscopic dysplasia may be found at a considerable distance from the gross affected site. In this study of 11 patients with Bowen's disease of the anus we report the results of a more conservative approach. All patients were treated by local excision of the gross affected areas only, and none of the patients required skin grafting. Seven patients were followed for a median of 34 months without macroscopic recurrence, including 3 patients with histologically proven dysplasia in the resection margins. Two patients, one with and one without dysplasia in the resection margins, developed recurrence within a year. One patient with an area of invasive carcinoma was first treated by local excision, but required an abdominoperineal excision 3 months later. One patient lost to follow-up had invasive carcinoma after 3 years. It is concluded that a conservative surgical approach in Bowen's disease of the anus is justified, provided the patients are followed closely.

Adult↗
PubMed1983

Conservative approach to the treatment of Bowen's disease of the anus.

Bowen's disease is a type of squamous carcinoma in situ with peculiar characteristics. It has a high incidence of associated internal malignancies and its progression to an invasive carcinoma has been described. We present seven patients with Bowen's disease of the perianal skin which have been treated conservatively with local excision and minimal margins of resection. No recurrences have been observed in this series up to the present time. Two patients had other associated malignancies; three patients had hypothyroidism. Local excision of the disease with minimal margins is advocated.

Adult↗
PubMed1999

Arsenic-related Bowen's disease, palmar keratosis, and skin cancer.

Chronic arsenical intoxication can still be found in environmental and industrial settings. Symptoms of chronic arsenic intoxication include general pigmentation or focal "raindrop" pigmentation of the skin and the appearance of hyperkeratosis of the palms of the hands and soles of the feet. In addition to arsenic-related skin diseases including keratosis, Bowen's disease, basal-cell-carcinoma, and squamous-cell carcinoma, there is also an increased risk of some internal malignancies. Arsenic-related diseases are common in areas of the world where the drinking water has a high arsenic content. In this paper, we describe a 35-year-old male patient who had arsenic-related keratosis, squamous-cell carcinoma in the palmar area of his left hand, and Bowen's disease on his left thigh. The patient worked in a borax mine for 15 years, so he was exposed to arsenic in drinking water, airborne arsenic in his workplace, and had direct contact. The patient was treated for 11 months for arsenic-related keratosis until an axillary lymph node metastasis occurred; the lesion was excised and diagnosed to be malignant. Bowen's disease was detected when the patient was being treated for cancer. No other malignancy was found. The patient is still receiving regular follow-up care.

Adult↗
PubMed1984

Preservation of anal function after total excision of the anal mucosa for Bowen's disease.

Six women with Bowen's disease of the anogenital area were treated by total excision of the anal mucosa, perianal skin and, in some cases, partial vulvectomy. Two patients had foci of microinvasive squamous carcinoma. Adequate tumor margins were determined by frozen sections. The resulting mucosal and cutaneous defects were grafted with medium split-thickness skin grafts applied to the anal canal and sutured circumferentially to the rectal mucosa. Grafts were held in place by a finger cot inserted in the anal canal and stuffed with cotton balls. Patients were constipated five or six days with codeine. The skin grafts healed per primam. One additional patient was similarly treated for a chronic herpetic ulceration of the anus and healed. Contrary to dire predictions, all patients were able to distinguish between gaseous and solid rectal contents and sphincter function was preserved. In one patient, Bowen's disease has recurred in the grafted perianal skin.

Adult↗