eMedicine Specialties > Dermatology > Malignant Neoplasms

Bowen Disease: Follow-up

Author: Mark P Eid, MD, Resident Physician, Department of Dermatology, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine
Coauthor(s): Bryan E Anderson, MD, Associate Professor, Department of Dermatology, Pennsylvania State University College of Medicine
Contributor Information and Disclosures

Updated: Dec 16, 2009

Follow-up

Further Outpatient Care

  • Patients with a history of any type of skin cancer should be evaluated with a total body skin examination every 6-12 months.

Deterrence/Prevention

  • Counsel at-risk individuals in the use of sunscreens, photoprotective clothing, and other measures to minimize further actinic damage. Frequent and routine screening should also be stressed to these patients.

Prognosis

  • The prognosis for patients with Bowen disease is excellent.

Patient Education

  • Patients with a history of Bowen disease should be counseled on safe sun behavior, to include avoiding the sun when it is most intense (between 10 am and 4 pm), wearing hats and other sun protective clothing, and using a dual-spectrum sunscreen with an SPF of 30 or higher.
  • For excellent patient education resources, visit eMedicine's Cancer and Tumors Center and Burns Center. Also, see eMedicine's patient education articles Skin Cancer, Skin Biopsy, and Sunburn.

Miscellaneous

Medicolegal Pitfalls

  • A failure to recognize Bowen disease or to perform a biopsy in patients suspected of having Bowen disease leads to a delay in treatment. A high degree of suspicion is needed in both sun-exposed and non–sun-exposed areas of the skin.
  • Surgery for patients with Bowen disease may cause bleeding, scarring, infection, deformity, and nerve damage. Discussing these risks with the patient prior to surgery is important.
  • Topical therapy of Bowen disease may result in recurrence or partial treatment, necessitating further biopsy and possible further surgical intervention with attendant risks as above.

Special Concerns

  • Rule out an invasive squamous cell carcinoma (SCC).
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Mark L. Welch, MD, Theresa Dressler Conologue, DO, FAAD, and Carrie A.H. Hall, MD, to the development and writing of this article.



More on Bowen Disease

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Differential Diagnoses & Workup: Bowen Disease
Treatment & Medication: Bowen Disease
Follow-up: Bowen Disease
Multimedia: Bowen Disease
References
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Further Reading

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Keywords

Bowen disease, Bowen’s disease, squamous cell carcinoma in situ, SCC, human papilloma virus 16, HPV 16, human papillomavirus 16

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Contributor Information and Disclosures

Author

Mark P Eid, MD, Resident Physician, Department of Dermatology, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Bryan E Anderson, MD, Associate Professor, Department of Dermatology, Pennsylvania State University College of Medicine
Bryan E Anderson, MD is a member of the following medical societies: American Academy of Dermatology, American Contact Dermatitis Society, and Pennsylvania Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Kelly M Cordoro, MD, Assistant Professor, Pediatric and Adult Dermatology, Department of Dermatology, University of California at San Francisco
Kelly M Cordoro, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Association of Professors of Dermatology, Dermatology Foundation, Medical Society of Virginia, National Psoriasis Foundation, Society for Pediatric Dermatology, and Women's Dermatologic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Edward F Chan, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine
Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine M Quirk, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania
Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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