Bowen’s Bowen disease is a rare skin disorder. Bowen disease was first described in the medical literature by a physician named JT Bowen in 1912.
Bowen’s disease (BD) is the name given to an intra-epidermal carcinoma that usually presents as a slowly enlarging,
Erythematous, scaly plaque on the lower legs of fair-skinned elderly women but other sites can also be involved. It can beconfused with eczema or psoriasis, but is usually asymptomatic and does not respond to topical glucocorticoids. It may also be hard to distinguish from superficial BCC. (Basal cell carcinoma). Transformation into SCC occurs in 3% or less.1
This is a precancerous condition. The lesion looks like brown indurated thickened mass covered with crust with well defined edge. When crusts are removed the papules can be seen to have oozy, slightly bloody, papilliferous surface. The lesion may ooze serosanguineous discharge.3
It presents as a slow-growing hard reddish indurated patch. Initially, it is well circumscribed, with a dry or eczematous surface. This verrucous lesion rarely metastasizes. Pruritus is the main complaint.2
- Exposure to UV radiations/ excessive sunlight
- Formation of mutant clone gene
- Uncontrolled growth of skin cells
- Red looking patch with an uneven boundary on an area of the skin, especially the sun exposed area.
- Bleeding lump
Incisional biopsy is usually undertaken to confirm the diagnosis. This shows an intra-epidermal carcinoma with no invasion through the basement membrane.1, 2
The presence of giant cells and corps rond are characteristic of the lesion.2
“Corps ronds” are isolated round keratinocytes with an eosinophilic cytoplasm, which is retracted from the nucleus and denser peripherally. Histology may also be obtained by curettage but this does not allow distinction from invasive SCC to be made, due to loss of tissue orientation and architecture.1
It occurs equally in the exposed and covered areas, particularly at sites of repeated trauma. Its usual victims are the old people. 50% of patients will develop malignant cancer of the skin in about 6 to 8 years time.3
While curettage or excision may be appropriate in somesettings, non-surgical therapies are generally preferred, especially on the lower legs. PDT, in particular, may be advantageous for BD on the lower leg because of relative selectivity of treatment and sparing of normal tissue, thus reducing the risk of poor healing and ulceration at this vulnerable site. Given the low risk of malignant transformation, the option of no active treatment may also be appropriate for some elderly frail patients.1
Antioxidant-rich foods are considered to be beneficial for cancer prevention. Other nutrients like vitamin c, zinc, vit E are also known to have beneficial effects for preventing cancerous conditions.
- Orange-colored vegetables and fruits, like carrots, squash, yams, cantaloupe, apricots, and mangoes contain beta-carotene
- Tomatoes, watermelon, guava, papaya, apricots, pink grapefruit, and blood oranges contain lycopene
- Fatty fish, like salmon, sardines, mackerel, herring, and albacore tuna, contain omega-3 fatty acids and vitamin D
- Walnuts and flaxseed are also good sources of omega-3 fatty acids
- Fortified milk and orange juice contain vitamin D
- Freshly brewed green or black tea contains polyphenols
- Brazil nuts (just 1-2 are needed), chicken, and grass-fed beef contain selenium
- Almonds, sunflower seeds, spinach, soybeans, and wheat germ contain vitamin E
- Beef, lamb, shellfish, and legumes (like hummus, chickpeas, lentils, and black beans) are good sources of zinc
Scope of Homeopathy
Homeopathic medicines given on symptomatic basis and characteristics of lesion help reduce the lesion. Homeopathy is known to be helpful for reducing the spread of cancer thus enhancing the overall prognosis of the case. Surgical intervention and homeopathy medicines are a recommended integrative approach.
- Ralston S.H., Penman I.D., Strachan M.W.J., Hobson R.P.Davidson’s, Principles and Practice of Medicine. 23rdrev.ed. Edinburgh; Churchill Livingstone/Elsevier; 2018. 1417p.
- Howkins &Bourne SHAW’S TEXTBOOK OF GYNAECOLOGY. 12threv.ed. New Delhi: B.I. Churchill Livingstone;1999. 407p
- Dr. Das S. A manual on Clinical Surgery. 13threv.ed. Kolkata: Dr. S. Das; 2018. 648p