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Bowen's disease: A favorable response to imiquimod.

Barad P, Fernandes J, Shukla P - Indian Dermatol Online J (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Venereology and Leprology, Goa Medical College, Bambolim Goa, India.

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Investigations revealed a normal hematological work up, a negative Mantoux test and sputum for acid-fast bacilli, a normal chest radiograph and a skin biopsy consistent with BD [Figures 2 and 3]... The patient was started on imiquimod 5% cream for 5 days in a week for 12 weeks which resulted in complete resolution of the lesion clinically [Figure 4] with no adverse effects... BD, a form of squamous cell carcinoma in situ, was described in 1912 by John T... Bowen... BD typically presents as an asymptomatic, discrete, slowly enlarging erythematous scaly patch or plaque with well-demarcated irregular border... Multiple therapeutic options are available for treatment of BD, which include medical and surgical... Medical treatment includes topical chemotherapy with 5-fluorouracil and imiquimod 5% cream, radiation therapy with X-rays or Grenz rays, and photodynamic therapy... Surgical options include simple excision with a minimum 4 mm margin around well-defined tumors of less than 2 cm in diameter and wide excision with at least 6 mm margin for larger or less-differentiated tumors or tumors in high-risk locations (e.g. scalp, ears, eyelids, nose, and lips)... Other surgical modalities include Mohs micrographic surgery, curettage and electrodessication, cryotherapy and laser ablation... Because most treatments have a recurrence risk, follow-up at 6 to 12 months is recommended to evaluate for any recurrence... As BD mimics many dermatoses, a high degree of clinical suspicion is required to make a diagnosis in those dermatoses which fail to respond to conventional topical and systemic therapies.

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Related in: MedlinePlus

Section of skin showing atypical keratinocytes having a windblown appearance with lymphocytic infiltrate in the dermis suggestive of BD. (H and E, ×400)
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Figure 3: Section of skin showing atypical keratinocytes having a windblown appearance with lymphocytic infiltrate in the dermis suggestive of BD. (H and E, ×400)

Mentions: A 70-year-old male having a sedentary lifestyle presented with history of a gradually increasing, single plaque over his back [Figure 1] for 20 years. There was no history of pain, ulceration, mucosal lesions, or any other skin lesions. Differential diagnoses of Bowen's Disease (BD), lupus vulgaris, and basal cell carcinoma were considered and the patient was investigated. Investigations revealed a normal hematological work up, a negative Mantoux test and sputum for acid-fast bacilli, a normal chest radiograph and a skin biopsy consistent with BD [Figures 2 and 3]. The patient was started on imiquimod 5% cream for 5 days in a week for 12 weeks which resulted in complete resolution of the lesion clinically [Figure 4] with no adverse effects. Biopsy done six weeks after treatment revealed a normal epidermis [Figure 5]. The patient has been on regular 3-monthly follow up for the past eighteen months, with no recurrence of the lesion.


Bowen's disease: A favorable response to imiquimod.

Barad P, Fernandes J, Shukla P - Indian Dermatol Online J (2014)

Section of skin showing atypical keratinocytes having a windblown appearance with lymphocytic infiltrate in the dermis suggestive of BD. (H and E, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228676&req=5

Figure 3: Section of skin showing atypical keratinocytes having a windblown appearance with lymphocytic infiltrate in the dermis suggestive of BD. (H and E, ×400)
Mentions: A 70-year-old male having a sedentary lifestyle presented with history of a gradually increasing, single plaque over his back [Figure 1] for 20 years. There was no history of pain, ulceration, mucosal lesions, or any other skin lesions. Differential diagnoses of Bowen's Disease (BD), lupus vulgaris, and basal cell carcinoma were considered and the patient was investigated. Investigations revealed a normal hematological work up, a negative Mantoux test and sputum for acid-fast bacilli, a normal chest radiograph and a skin biopsy consistent with BD [Figures 2 and 3]. The patient was started on imiquimod 5% cream for 5 days in a week for 12 weeks which resulted in complete resolution of the lesion clinically [Figure 4] with no adverse effects. Biopsy done six weeks after treatment revealed a normal epidermis [Figure 5]. The patient has been on regular 3-monthly follow up for the past eighteen months, with no recurrence of the lesion.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Venereology and Leprology, Goa Medical College, Bambolim Goa, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Investigations revealed a normal hematological work up, a negative Mantoux test and sputum for acid-fast bacilli, a normal chest radiograph and a skin biopsy consistent with BD [Figures 2 and 3]... The patient was started on imiquimod 5% cream for 5 days in a week for 12 weeks which resulted in complete resolution of the lesion clinically [Figure 4] with no adverse effects... BD, a form of squamous cell carcinoma in situ, was described in 1912 by John T... Bowen... BD typically presents as an asymptomatic, discrete, slowly enlarging erythematous scaly patch or plaque with well-demarcated irregular border... Multiple therapeutic options are available for treatment of BD, which include medical and surgical... Medical treatment includes topical chemotherapy with 5-fluorouracil and imiquimod 5% cream, radiation therapy with X-rays or Grenz rays, and photodynamic therapy... Surgical options include simple excision with a minimum 4 mm margin around well-defined tumors of less than 2 cm in diameter and wide excision with at least 6 mm margin for larger or less-differentiated tumors or tumors in high-risk locations (e.g. scalp, ears, eyelids, nose, and lips)... Other surgical modalities include Mohs micrographic surgery, curettage and electrodessication, cryotherapy and laser ablation... Because most treatments have a recurrence risk, follow-up at 6 to 12 months is recommended to evaluate for any recurrence... As BD mimics many dermatoses, a high degree of clinical suspicion is required to make a diagnosis in those dermatoses which fail to respond to conventional topical and systemic therapies.

No MeSH data available.


Related in: MedlinePlus