Bowen's Disease
Also known as: SCC in Situ
Early-stage SCC confined to the top skin layer. A persistent, well-defined red scaly patch - 3-5% progress to invasive cancer.
What to look for
Side-by-side comparison
Normal skin
No persistent red patches
Bowen's disease
Well-defined red scaly patch
Bowen's disease is squamous cell carcinoma in situ - malignant cells present but not yet invaded beyond the epidermis. It represents the stage between actinic keratosis and invasive SCC.
It presents as a slowly enlarging, well-defined, red or pink scaly patch with sharp irregular borders. Unlike eczema, it is typically a single persistent patch rather than multiple lesions.
Without treatment, approximately 3-5% progress to invasive SCC. A key diagnostic clue is a single, well-defined scaly patch that does not respond to steroid creams or antifungals.
Quick self-check
Does this look like bowen's disease? Answer 2 questions.
Is it a single, well-defined scaly patch (not multiple)?
Has it persisted despite treatment attempts?
Risk factors
- Chronic sun exposure
- Fair skin
- Age over 60
- Immunosuppression
- Arsenic exposure
- HPV infection (genital form)
When to see a dermatologist
- ⚠A persistent red scaly patch not responding to eczema or fungal treatments
- ⚠A single slowly growing patch on the lower leg or sun-exposed area
- ⚠Any scaly patch present for months without healing
Often confused with
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Full ABCDE check →Frequently asked questions
Is Bowen's disease cancer?
Technically yes - SCC in situ. But the cancer cells are confined to the epidermis and cannot spread. It is the earliest, most treatable stage. Without treatment, 3-5% progress to invasive SCC.
Can it be mistaken for eczema?
Very commonly. Key differences: Bowen's is usually a single well-defined patch; eczema tends to be multiple. Bowen's does not respond to steroid creams; eczema typically improves. Persistent single patches failing standard treatment should be biopsied.