in men usually occurs on the scalp and ears, while in women, the lower legs are the most common site.
Arsenic exposure has been associated with 3 types of skin cancers namely Bowen's disease
basal cell carcinoma and squamous cell carcinoma.
Seven patients have been reported to have subungual Bowen's disease
involving two or more digits.[4,29-31] Two of these patients had been exposed to significant amounts of ionizing radiation.[4,31] Three cases of subungual Bowen's disease
have been reported in association with uterine cervical carcinoma.[6,17,31] We are unaware of any other reports of malignancies occurring in association with Bowen's disease
of the nail.
In the belief, however, that a terminology based on the pathology of a lesion is preferable to an eponymous nomenclature, it would seem proper, in describing pre-invasive neoplasia of the conjunctival epithelium, to abandon the commonly applied ascription 'Bowen's disease
' in favour of the more explicit term 'intraepithelial squamous cell carcinoma.'
manifests itself as a slowly enlarging erythematous patch of sharp but irregular outline, showing little or no infiltration.
Even though the marked atypicality of the epidermal cells in Bowen's disease
includes the cells of the basal layer, the border between the epidermis and dermis everywhere appears sharp, and the basement membrane remains intact.
Histopathological Mean age diagnoses n (%) (years) M/F Primary malignancy BCC 124 (61.4) 63.3 82/42 SCC 33 (16.3) 58.1 22/11 MF 14 (6.8) 30.7 11/3 DFSP 12 (5.8) 32.3 8/4 MM 7 (3.7) 65.1 6/1 Bowen's disease
3 (1.5) 62.7 2/1 Adnexal carcinoma 3 (1.5) 68.3 3/0 PDS 1 (0.5) 85.0 1/0 Kaposi's sarcoma 1 (0.5) 80.0 1/0 MCC 1 (0.5) 75.0 1/0 Metastatic Metastatic 3 (1.5) 48.0 2/1 adenocarcinoma Total 202 (100) 139/63 BCC--Basal cell carcinoma, SCC--squamous cell carcinoma, MF--mycosis fungoides, DFSP--dermatofibrosarcoma protuberans, MM--malignant melanoma Table 2--Distribution of the cases according to the locations.
The important consideration in these cases is not the horn, but the underlying pathology which may be benign (Seborrheic keratosis, viral warts, histiocytoma, inverted follicular keratosis, verrucous epidermal nevus, molluscum contagiosum, etc.), premalignant (Solar keratosis, arsenical keratosis, Bowen's disease
) or malignant (Squamous cell carcinoma, rarely basal cell carcinoma, metastatic renal carcinoma, granular cell tumour, sebaceous carcinoma or Kaposi's sarcoma.
They have been described in chronic sun-damaged skin with precancerous lesions (5-7), in the periphery of hyperkeratotic Bowen's disease
(8) and basal cell carcinoma (9), in poromas (10), in psoriasis (11), and in cutaneous leishmaniasis (12, 13).
(1,2) Bowen's disease
was firstly described by John T.
Actinic keratosis, Bowen's disease
, invasive SCC, and more rarely basal cell carcinoma occur as a result of this transformation.
Usman, "Bowen's disease
of the nipple--a new method of treatment," The Breast, vol.