Medication Summary

The goals of therapy for Bowen disease are to reduce morbidity and to prevent complications.

Class Summary

These are topical agents that may be used in the management of Bowen disease.

5-Fluorouracil (Efudex, Carac, Adrucil, Fluoroplex)

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5-Fluorouracil administered topically under occlusion, following the use of keratolytic or cryotherapy, or by iontophoresis (an electrogradient-driven chemical delivery system), can be used. It interferes with DNA synthesis by blocking methylation of deoxyuridylic acid and inhibits thymidylate synthetase, which subsequently reduces cell proliferation.

Imiquimod (Aldara)

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The precise mechanism of action for the treatment of Bowen disease is unknown. It may increase tumor infiltration of lymphocytes, dendritic cells, and macrophages. It is indicated when surgical methods are not appropriate.

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Media Gallery

Squamous cell carcinoma in situ, Bowen disease. Courtesy of Hon Pak, MD.
Bowen disease right temple.
Erythroplasia of Queyrat, squamous cell carcinoma in situ of the glans penis.

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Author

Mary V Kaldas, MD Resident Physician in Anatomic Pathology, National Institutes of Health

Disclosure: Nothing to disclose.

Coauthor(s)

Mark P Eid, MD Founder and Director, Virginia Dermatology and Skin Surgery Center

Mark P Eid, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, Pennsylvania Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

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, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Kelly M Cordoro, MD Assistant Professor of Clinical Dermatology and Pediatrics, Department of Dermatology, University of California, San Francisco School of Medicine

Kelly M Cordoro, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Medical Society of Virginia, Society for Pediatric Dermatology, Women's Dermatologic Society, Association of Professors of Dermatology, National Psoriasis Foundation, Dermatology Foundation

Disclosure: Nothing to disclose.

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, Pennsylvania Medical Society, American Contact Dermatitis Society

Disclosure: Nothing to disclose.

Acknowledgements

Theresa Dressler Conologue, DO, FAAD Physician, Department of Dermatology, Geisinger Medical Center

Disclosure: Nothing to disclose.

Carrie A H Hall, MD Resident Physician, National Capital Consortium Dermatology Residency Program, National Naval Medical Center

Disclosure: Nothing to disclose.

Mark L Welch, MD Clinical Assistant Professor, Department of Dermatology, Howard University; Assistant Professor, Department of Dermatology, Uniformed Services University of the Health Sciences

Disclosure: Nothing to disclose.