Bowen’s Disease:Clinical, Pathological Features And Comparison Of Therapies

Objective:To analyze the clinical and pathological features, for (the) purpose of finding the probable pathogenesy and improving the level of diagnosis and differential diagnosis. And comparing different therapies of Bowen’s disease, to explore therapies of highly cost-effective.Methods:The clinical data of66cases of Bowen’s disease collected from dermatology department of the first people’s hospital of Changzhou city from1994to2012, were retrospectively analyzed on the their lesions, sites, sizes, number and the change of lesions and relapse rate after treatment. The pathological features were observed by Olympus optical microscope.Results:Of66cases with Bowen’s disease, there are35men and31women, age23to89years. The peak age of onset is between50and70years.92.4%(61/66) skin lesions were located in non-exposed parts, such as trunk, lower extremity, genitalia and so on.94%(62/66) skin lesions were solitary.89.4%(59/66) patients had no subjective symptom. One of patients has carcinoma of gastric cardia and lung cancer, another patient has clear cell carcinoma of kidney. Pathologically, The cells displayed severe atypical hyperplasia, which almost involved the whole epidermal layer.cytoplasm of10specimens was vacuolation. Sackful Inflammatory cells with focal or band-like infiltration were seen in the superficial layer of corium of53specimens. Of66cases with Bowen’s disease,54patients underwent surgical ablation with one patient recurrence.10patients underwent ALA-PDT with8patients complete remission and2patients recurrence.2patients underwent oral Acitretin, whose skin lesions become thinner. This two patients are followed-up now. Conclusions:The age of Bowen’s disease onset is becoming younger and younger, and the data has been showed this disease may be associated with tumors, so comprehensive physical examination is necessary. Pathology suggests is probably related to virus infection. Operation is the main treatment of choice for Bowen’s disease. For the special parts (such as face, genitalia) ALA-PDT is considered. Oral Acitretin is suitable for the lesions that are big or multiple.