Bowen's Disease vs Psoriasis

How to tell the difference — key features compared side by side.

Feature
Bowen's Disease
Psoriasis
Category
Pre-cancerous
Common
Key feature
Early-stage SCC confined to the top skin layer. A persistent, well-defined red scaly patch - 3-5% progress to invasive cancer.
Chronic autoimmune condition causing thick, silvery scaly patches. Affects 2-3% of the population. Not contagious.
Risk factors
Chronic sun exposure; Fair skin; Age over 60
Family history of psoriasis (strongest risk factor); Stress (major trigger for flares); Obesity
Action needed
A persistent red scaly patch not responding to eczema or fungal treatments
Persistent thick, scaly patches that do not respond to moisturizers

Bowen's Disease

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.

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Psoriasis

Psoriasis is a chronic autoimmune condition in which the immune system mistakenly accelerates skin cell growth. Normal skin cells mature and shed in about a month; in psoriasis, this process takes only 3-4 days, causing cells to pile up into thick, silvery-white scales on red, inflamed patches.

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Does yours look more like bowen's disease?

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?

Still not sure?

Our full ABCDE checker evaluates 5 clinical criteria dermatologists use.

Full ABCDE check →