Beginning >> Diseases >> Tumors >> Bowen's illness

Bowen's illness

Bowen's illness — an intra epidermal new growth which in most cases remains in situ cancer.

Epidemiology

Usually arises at advanced age equally often at men and women.

Classification

The following clinical versions are allocated:
• anulyarny;
• verrukozny;
• pigmental;
• Bowen's illness of a nail bed.

Etiology and pathogeny

Bowen's illness develops more often on the sites of skin which are exposed to solar radiation. Except an actinic factor as carcinogens compounds of arsenic and hydrocarbons, mustard gas are considered.

Clinical signs and symptoms of an illness of Bowen

It is characterized by existence usually of one sharply limited blyashkovidny center of the defeat which is slowly growing on the periphery at the expense of more active, slightly raised edge which is shelled or covered with crusts, roundish or oval outlines is more rare — irregular shape. The surface is uneven, granular, can be slightly warty. The superficial erozirovaniye, an ulceration with formation of the ulcers which are partially cicatrizing and at the same time increasing on a surface are observed.
The most frequent localization — a trunk, upper extremities, area of a crotch.

The diagnosis and the recommended clinical trials

The biopsy is necessary for confirmation of the diagnosis.
The hyperkeratosis, focal parakeratosis are characteristic of a pathomorphologic picture of an illness of Bowen an acanthosis with lengthening and a thickening of epidermal outgrowths. Acanthceous cells are located randomly, many of them with the expressed atypia, with large hyperchromic kernels. Often figures of mitoses meet. A focal dyskeratosis in the form of concentric beddings of the keratosic cells reminding "horn pearls". Some cells strongly of a vakuolizirovana, have similarity to Pedzhet's cells, however the last have no intercellular bridges. Upon transition of an illness of Bowen to planocellular cancer there is submersible growth in a derma akantotichesky a basal membrane, tyazhy with disturbance, and sharply expressed polymorphism of cells in these tyazha.

Differential diagnosis

The Verrukozny form of an illness of Bowen can imitate a vulgar wart, a seborrheal keratosis with the inflammation phenomena.
At localization on skin of a mammary gland of an illness of Bowen it is necessary to differentiate with Pedzhet's illness.
The pigmental form of an illness of Bowen can be similar to a pigmental bazaliomy or pagetoid melanoma of in situ.
Bowen's illness of a nail needs to be differentiated with a fungal infection, a paronychia, a piogenic granuloma, verrukozny tuberculosis, a glomal tumor, a keratoacanthoma, planocellular cancer.

General principles of treatment of an illness of Bowen

Apply surgical excision, laser evaporation, a cryolysis, cytostatics:
Ftoruratsil, 1 — 2 — 5% ointment, locally 2 r / days, 1 week, then break of 1 week and repeated courses (only 4 — 6).

Forecast

Frequency of transformation of an illness of Bowen in invasive planocellular cancer, according to various authors, varies from 11 to 80%.
 
"Diseases of heavy chains   Vipoma"