An area of redness caused by Bowen’s Disease.

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What is Bowen’s disease?

Bowen’s disease is a type of skin disease that is characterised by a reddish-brown, crusted patch on a person’s skin. It resembles other skin conditions like dermatitis and psoriasis and can occur on any part of the body or in the mucous membrane, although the lower legs are most commonly affected. Bowen’s disease can be considered an early stage of a type of skin cancer known as squamous cell carcinoma. Also known as squamous cell carcinoma in situ, Bowen’s disease was derived from the dermatologist who first described the disease, Dr John T Bowen.
Fair skin and exposure to sunlight are the main risk factors for this disease. Women are more susceptible than men, and most cases occur in people over 40 years. The condition isn’t contagious and treatment is usually successful.

Causes
There are various causes of Bowen’s disease, some of which are very similar to other types of skin conditions, constant exposure to direct sunlight being an example. However, there are several causes and risk factors that are exclusively linked to it, namely:
• Exposure to arsenic, or chronic arsenical intoxication
• Viral infection from the human papillomavirus or HPV
• Disease and conditions that affect the immune system such as AIDS.

Signs and symptoms
This condition can spread slowly throughout the body. The signs include:
• Flat, scaly, red and slightly raised patches.
• A single patch or a number of patches.
• Patches with irregularly shaped edges which are distinct from the surrounding skin.
• The patch or patches grow very slowly.
• Patches which present no symptoms, so they are often overlooked.
• Occasionally sore, irritated or bleeding patches.
• Raised spots that may look like warts.
One of the most common symptoms of Bowen’s disease is itching in the affected region. The affected area can even feel painful. Because it is an early form of squamous cell carcinoma, signs, symptoms and the physical appearance of Bowen’s disease are similar.

Risk factors
The cause of Bowen’s disease is unknown, but suspected risk factors include:
• Gender – Exists more in women.
• Age – It tends to be found more in people over 40 years and elderly women are particularly prone.
• Sun exposure – It is more common in sunny countries. However, since areas of the body that are not normally exposed to sunlight (such as the genitals or anus) can be affected, sun exposure can’t be the sole risk factor.
• Arsenic exposure – Such persons are at greater risk.
• Systemic immunosuppression therapy – This is required by organ transplant recipients to prevent organ rejection.

Prevention
There are certain measures a person can take to help prevent Bowen’s disease:
• Avoidance of long, direct exposure to the sun.
• Consistent application of sunscreen when outside or exposed to the sun.
• Wearing of protective clothing.
These are just a few methods for protection. However, researchers have found that where the disease appears in areas of the body that were not exposed to the sun, it was attributable to risk factors like arsenic intoxication or HPV.

Treatments
According to Cancer Research UK, there are several available treatment methods:
• Chemotherapy – This particular form of treatment requires the application of special cream to the affected area. Side effects can include soreness and reddening of the affected area.
• Radiotherapy – Similar to other forms of skin cancer, radiotherapy is an effective way of destroying cancerous cells while minimising the damage to healthy skin surrounding the areas being treated.
• Cryosurgery – The lesion is destroyed with intense cold. This type of treatment has a success rate of around 90 per cent when conducted by specialists.
• Curettage – The lesion is scraped off the skin. It may be used with cauterisation, where the skin is lightly burnt with an electric current. It has a success rate of around 90 per cent when performed by dermatologists.
• Photodynamic therapy (PDT) – Is a special type of light used to destroy the lesion. Success rates are in the order of 80 per cent with a specialist.
• Topical creams – These are applied to the lesion to kill its cells. They include 5-fluorouracil cream and imiquimod cream. Success rates are similar to PDT.
• Surgery – The lesion is cut out and the wound sutured closed. This treatment has a near 100 per cent success rate, but will leave a surgical scar.
Early diagnosis is key for treating and containing Bowen’s disease. The more time this disease has to spread throughout a person’s body, the more difficult it will be to treat the affected area.
Your feet mirror your general health . . . cherish them!

Leana Huntley is an English trained foot health practitioner attached to
ALMAWI Limited The Holistic Clinic.
E-mail info@almawiclinic.com or visit the website: www.almawiclinic.com
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