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MSRA Dermatology [3] > [12] Bowen's Disease > Flashcards

[12] Bowen's Disease Flashcards

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Dermatology Board Prep flashcards
1
Q

What is Bowen’s disease also known as?

A

SCC in situ

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2
Q

What is Bowen’s disease?

A

A neoplastic skin disease that can be considered as an early stage or intra-epidermal form of SCC

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3
Q

What is the risk of progression from Bowen’s disease to SCC in typical cases?

A

Around 3%

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4
Q

What is Bowen’s disease a malignancy of?

A

Keratinocytes in the epidermal layer

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5
Q

What are the risk factors for Bowen’s disease?

A
  • Sun damage
  • Other irradiation damage
  • Carcinogens
  • HPV
  • Immunosuppression
  • Chronic skin injury or dermatoses
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6
Q

What other forms of radiation damage can increase risk of Bowen’s disease?

A
  • Radiotherapy
  • Photochemotherapy
  • Sunbeds
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7
Q

Give a carcinogen that can cause Bowen’s disease?

A

Arsenic

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8
Q

How does Bowen’s disease typically present?

A

A slow growing erythematous hyperkeratotic patch or plaque with an irregular border

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9
Q

What are the features of Bowen’s disease?

A
  • Erythematous
  • Hyperkeratotic/scaling
  • Plaque/patch
  • Irregular border
  • Well defined
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10
Q

What additional features may be present in Bowen’s disease?

A

Crusting/erosion

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11
Q

How big generally is Bowen’s disease?

A

A few cm

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12
Q

What is the size of the Bowen’s disease proportional to?

A

The duration

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13
Q

What is the main symptom of Bowen’s disease?

A

Bleeding of the lesion

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14
Q

Where is Bowen’s disease most commonly found on the skin?

A

Sun exposed areas

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15
Q

How is Bowen’s disease typically diagnosed?

A

Clinically with a dermatoscope

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16
Q

If there is doubt about Bowen’s disease what is required for histological diagnosis?

A

Punch biopsy

17
Q

What are the differentials for Bowen’s disease?

A
  • Discoid eczema
  • Psoriasis
  • Lichen planus
  • Actinic keratosis
  • Superficial BCC
  • Malignant melanoma
18
Q

What is the recurrence rate for all treatments for Bowen’s disease?

A

5-10%

19
Q

What influences the choice of treatment in Bowen’s disease?

A
  • Age of patient
  • Number of lesions
  • Size of lesions
  • Location of the lesions
20
Q

What are the treatment options for Bowen’s disease?

A
  • Topical treatments
  • Cryotherapy
  • Surgery
  • Photodynamic therapy
21
Q

What is usually the first line therapy for Bowen’s disease?

A

Topical treatment with 5-FU cream

22
Q

When is 5-FU cream useful in Bowen’s disease?

A

For large lesions with a history of poor healing

23
Q

What can improve the efficacy of 5-FU in Bowen’s disease?

A

Preceding laser or cryotherapy

24
Q

What is used in cryotherapy of skin lesions?

A

Liquid nitrogen

25
Q

What are the advantages of cryotherapy in Bowen’s disease?

A
  • Simple
  • Quick
  • Effective
26
Q

What are the different surgical techniques for treating Bowen’s disease?

A
  • Curettage with cautery
  • Surgical excision
  • Moh’s microqurgery
27
Q

What happens in curettage of Bowen’s disease?

A

Abnormal skin is scraped off under local anaesthetic and additional tissue is destroyed with electrocautery

28
Q

What excision margin is recommended in excisional surgery of Bowen’s disease?

A

5mm

29
Q

When is Moh’s microsurgery useful in Bowen’s disease?

A

For areas that require skin sparing e.g. fingers, nails and penis

30
Q

What is photodynamic therapy for Bowen’s disease?

A

Preparing by removing crust/scale and using a photosensitising cream. Lesion is then exposed to a light source which burns away the area

31
Q

When is photodynamic therapy useful in treating Bowen’s disease?

A

Treating large lesions

32
Q

What are the advantages of photodynamic therapy for Bowen’s disease?

A

Better tolerated and better cosmesis than cryotherapy

33
Q

What is the disadvantage of photodynamic therapy in Bowen’s disease?

A

May be painful

34
Q

What is the main complication of Bowen’s disease?

A

Progression to invasive SCC

MSRA Dermatology [3] (26 decks)

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