The Clinical Features And Treatment Of 60 Cases Of Bowen’s Disease

Background and Objective:Bowen’s disease is a squamous cell carcinoma that is localized to the epidermis,also known as squamous cell carcinoma in situ.The lesions can be confined to the epidermis for a long period of time.However,once the skin lesions develop further,they may break through the basement membrane and show invasive growth,progressing to squamous cell carcinoma with a metastasis rate as high as 37%.Therefore,early diagnosis and treatment are very important.Based on the clinical features,nature and pathological features of Bowen’s disease,this study intends to make a statistical analysis of Bowen’s disease and analyze its clinical diagnosis and treatment.To further understand the pathologic features and histopathological features of Bowen’s disease,so as to improve the diagnosis of Bowen’s disease awareness and early diagnosis and treatment,reduce the misdiagnosis rate.And it is expected to provide some clinical reference for the rational choice of treatment methods in combination with different cases of patients.Methods:The clinical and pathological data of patients diagnosed with Bowen’s disease who were diagnosed in our Department of Dermatology between 2007 and 2016 and were histopathologically examined were collected.We conducted a systematic retrospective analysis of the age of onset,skin lesion location,skin lesion color and surface condition,and misdiagnosis of 60 patients with Bowen’s disease whose data were kept intact.Results:The incidence age of patients with Bowen’s disease ranged from 28 to 86 years old,and the average age was 56.85 years.The duration of the disease varies,and the course of illness can last up to 40 years.Single lesions are the most common,accounting for up to 81.7%,of which 43 occur in non-exposed areas and 5 occur in exposed areas.33.33%of the lesions were red and 63.33% were brown to black.In addition,lesions were mostly papules or patches.On this basis,2 cases had verrucous lesions on the surface,10 cases were accompanied by scales and scab,and 7 cases had breakage and exudation.Its clinical manifestations are diverse,which can be confused with other diseases such asseborrheic keratosis and squamous cell carcinoma,and the misdiagnosis rate can be as high as 30%.Conclusion:This study found that the incidence of Bowen disease is still mainly in the elderly over 50 years old,but the number of young people under 40 years old accounted for20% of the study.,and the incidence of the disease showed a certain trend of youth.The ratio of skin lesions to non-exposed parts and exposed parts is 7.57:1,witch is not the same as the characteristic of the exposed part of the disease such as the head and the face.This is might related to the limitation of the representation of sample size.The clinical diagnosis and histopathological diagnosis of 30% of patients were inconsistent at the time of initial diagnosis.The rate of misdiagnosis was high,which may be closely related to factors such as lack of specificity of skin lesions and physicians’ lack of Bowen’s disease alertness.The treatment of this disease is the most commonly used in surgical resection,and photodynamic therapy is gradually being carried out in clinical practice.The treatment of patients should be combined with a variety of factors.