Squamous cell carcinoma insituSquamous cell carcinoma insitu(Bowen disease)(Bowen disease)

Yulia Farida YahyaYulia Farida YahyaDep I Kesehatan Kulit& KelaminDep I Kesehatan Kulit& Kelamin

FK UNSRI-RSUP M Hoesin FK UNSRI-RSUP M Hoesin PalembangPalembang

At a glanceAt a glance

♥ Bowen disease (BD) squamous cell carcinoma (SCC) in situ potential progress SCC

♥ Etiologic factors UVR exposure, chronic arsenicism, previous therapy with psoralen & UVR to ionizing radiation & infection with human papilloma virus (HPV)

Clinical variant Clinical variant pigmented, pigmented, intertriginous, periungual &subungual BDintertriginous, periungual &subungual BD

Histopathologic featuresHistopathologic features full-tickness full-tickness epidermal atypia with adnexal epidermal atypia with adnexal involvementinvolvement

Lesion progress to invasion carcinoma in Lesion progress to invasion carcinoma in 3% - 5% of cases3% - 5% of cases

At a glanceAt a glance

Treatment methodTreatment method incision & Mohs incision & Mohs micrographic margin, whichpermit micrographic margin, whichpermit histopathologic evaluation to exclude histopathologic evaluation to exclude invasive SCCinvasive SCC

Curratage treatment of BD Curratage treatment of BD may miss may miss appendegeal involvementappendegeal involvement

Topical Therapy may be used in areas Topical Therapy may be used in areas difficult to treat with other methoddifficult to treat with other method

At a glanceAt a glance

Large plaque Bowen disease of the leg

BD typicallyslowly enlarging,pink erythematous thin plaque,well demarcated, crust or scale resembling psoriasis

Bowen disease showing full-tickenes atypia epithelium

Clinical manifestation

Differential diagnosisDifferential diagnosis

Differential diagnosisDifferential diagnosis

Treatment Treatment

Prognosis Prognosis

The risk untreated BDThe risk untreated BDprogress progress invasive carcinomainvasive carcinoma approximately 3 approximately 3 – 5%– 5%

BD is marker for high risk developing a BD is marker for high risk developing a subsequent NMSCsubsequent NMSC estimated 30 – estimated 30 – 50%50%

BD involving vulva region in femaleBD involving vulva region in female associated increased of uterine, associated increased of uterine, cervical & vaginal cancer, posibly due cervical & vaginal cancer, posibly due to HPV infectionto HPV infection