Bowen’s Disease Dermatologist2019-05-21T11:59:38+00:00

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Bowen’s disease, also known as squamous carcinoma in situ, is a condition where cancerous cells are found in the topmost layer of the skin

IN THESE VIDEOS, I EXPLAIN THE SYMPTOMS AND CAUSES OF BOWEN’S DISEASE – AND HOW TO TREAT IT

In the videos above, I explain things in a simple way that applies to most people who have Bowen’s disease. Of course, no video or website can replace the value of a personalised consultation. At your consultation, you can have your skin carefully examined and get an expert recommendation to help you resolve your condition.

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Treatment helps people of all ages take control of their skin condition and get their life back.

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How does Bowen’s disease impact people on a day-by-day basis?

BOWEN’S DISEASE IS NOT WORRISOME, AND I TREAT IT AS SUN DAMAGE. OCCASIONALLY, IT CAN TURN INTO SOMETHING MORE SERIOUS, A SKIN CANCER KNOWN AS SQUAMOUS CELL CARCINOMA, WHICH IS WHY YOU SHOULD HAVE TREATMENT

What does it look like and where can you get it?

Bowen’s disease can present with flat but scaly, red patches on sun-exposed skin. Commonly affected areas include the lower legs, hands but also the head and neck.

How do they feel?

Patches may be completely asymptomatic, or they can be itchy and sometimes sore.

Can Bowen’s disease become more serious?

Bowen’s patches are generally slow-growing, but if an ulcer or new growing lump were to develop within it, this could be an indication of squamous cell carcinoma.

What precautions should you take?

Having had Bowen’s disease means that your skin is susceptible to sun damage and therefore you may be at an increased risk of certain types of skin cancer. The primary consideration is to look after your skin in the sun by taking special sun precautions.

Should I have Bowen’s disease treated?

Even though patches of Bowen’s disease are often asymptomatic and the risk of progression to squamous cell carcinoma is low, I recommend that you have your Bowen’s disease treated. Treatment usually is straightforward, and patients tolerate it well. It will also reduce the likelihood of an squamous cell carcinoma arising from this area.

What my patients love about my service

MY PATIENTS ARE MY BEST PROMOTERS

Please pass on my thanks to Dr Pratsou for her assessment on my continued taking of roaccutane.

She was completely right, I didn’t need a new course, I needed to move away from the drug. The creams she gave me and Cetaphil recommendation have meant my skin has been the best it’s ever been (ongoing and since I saw her) ALL SUMMER :))))) I’ve had zero problems…and I’m loving it.

Thank you once again.


Phillip, Acne

“Dear Dr Pratsou,

Following the consultation today I feel it appropriate to say thank you for your help in dealing with my rosacea.

On each occasion, I have visited your department I have noticed the kindness and cheeriness of all the staff I have encountered and particularly wanted to say that you made me feel at ease with your calmness and excellent manner.

All is much appreciated.”


Anne, Rosacea

“Thank you very much!!

You three were (and are) a great team!

I will remember you.

You made me feel comfortable.”


Ellie

“Tania,

Please pass to Dr Pratsou my thanks for her skilled work.

The wound is healing beautifully and now the stitches are out it looks as though it will be almost invisible once fully healed.”


Graham, Skin cancer removal

“Dear Dr Penelope, Rena & the team, (I can’t remember the nurse’s name who helped me during my 2 procedures at the Spire!)

I wanted to thank you for your support and help during a very difficult time. You guys do a wonderful job – and we are eternally grateful for your help.”


Clarissa, Skin cancer

“I would like to put on record how impressed I was with the operation you performed for the removal of the SCC on my neck. I cannot even see where the cut or the stitches were! I am indeed very grateful for the excellent work you do.”


Harry, Squamous Cell Carcinoma

“Dear Dr Pratsou,

I am very grateful to you for your diagnosis, recommended treatment and advice. Your letter to my GP sets out both the course of events, and your own analysis of probable condition and possible cause, clearly summarising our discussion.

I hope there will be no recurrence but I will certainly come back to you if there is.”


Ryan, Skin rash

“Dear Tania,

Please pass on my thanks to Dr Pratsou. I saw her this morning for a mole check. She was so lovely and reassuring. Please also thank the two nurses who assisted her during the mole removal procedure. I was very nervous, but they were very efficient, which meant I did not have too long to think about it, but most of all they were very kind. They kept me distracted and calm, which made a huge difference. Thank you also for your efficiency in both booking me in so quickly.”


James, Mole removal
Dear Ms. Pratsou,

I am writing to thank you for the care you have given me in the past few months. From the moment I walked into your consulting room with a lesion on my cheek, a lesion that I fully expected to be some sort of skin cancer (and it was), you have been thorough, reassuring, respectful and in every way professional.

You recognised that I had some insight into the condition of my skin and the procedures required to treat me. You listened to me. You projected expertise and compassion.

During the procedure to remove the growth you ensured that the atmosphere in the treatment room remained not only calm, but actually pleasant. Had it not been that you were excising a growth and sewing me up, I almost felt as if you, me and the nurse were at some sort of women’s discussion group. The time flew by. I had zero anxieties about the procedure and as we both know now, the wound healed flawlessly.

Thank you for your expertise and your communication skills and all round good nature. I feel very lucky.


Karen Tatom, Skin cancer removal

We have replaced the images and names of real patients who provided these testimonials to protect their privacy.

The first step to feeling in charge of your skin is to book an initial consultation

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How it works

FEEL IN CHARGE OF YOUR SKIN IN 3 EASY STEPS

STEP 1 – CALL US
STEP 2 – LET’S MEET
STEP 3 – RESOLUTION
CONTACT MY STAFF

Give us a call on 0118 373 5198 and we’ll help guide you towards a first appointment.

MEET WITH ME

I’ll see you and examine your skin before I recommend treatment. In some cases, I can begin treating your condition on the same day.

FEEL IN CHARGE OF YOUR SKIN

I’ll guide you down the road towards a resolution of your skin condition so that you can get back to normal life.

More information about Bowen’s disease

FOR THOSE WHO WANT THE DETAILS

Bowen’s disease, also known as squamous carcinoma in situ, is a condition where cancerous cells occur in the topmost layer of the skin.

It is not a worrying condition, and I treat it as sun damage.

It can occasionally turn into something more serious, known as squamous cell carcinoma, which is why you should have treatment.

Bowen’s disease symptoms and lifestyle impacts:

  • Bowen’s disease can present with flat but scaly red patches on sun-exposed skin
  • commonly affected areas include the lower legs, hands but also the head and neck.
  • patches may be completely asymptomatic, or they can be itchy and sometimes sore.
  • Bowen’s patches are generally slow-growing, but if an ulcer or new growing lump were to develop within it, this could be an indication of squamous cell carcinoma.

The leading cause of Bowen’s disease is cumulative sun exposure resulting in sun damage. This sun damage affects cells in the topmost layer of the skin.

Risk factors for Bowen’s disease include fair skin, outdoor hobbies or outdoor work, living in sunny climates, or a compromised immune system.

Sometimes, Bowen’s disease can present in the genital area, and is associated with exposure to the human papillomavirus (HPV).

I offer a full skin examination with dermoscopy to look for other areas of sun damage and signs of inflammatory skin problems that can cause scaly red patches (for example, psoriasis).

Sometimes, you might need a skin biopsy to so that I can make a definitive diagnosis to distinguish from psoriasis or eczema or to rule out early skin cancer.

There are many treatment options. The choice depends on the size and site of Bowen’s disease, the number of areas affected, and your preference.

Cryotherapy

This is treatment with a gentle freezing spray, liquid nitrogen. Cryotherapy is generally a one-off treatment performed in the clinic on the same day in suitable patients.

Topical preparations, including Efudix cream and Aldara cream

I may advise that you use creams in cosmetically sensitive areas such as the lips, eyelids, genital area, or when other treatments such as cryotherapy can result in delayed healing (for example, in the lower legs). The effectiveness of these treatments rely on you using them at home and as instructed. Topical preparations typically result in inflammation, which is nothing to worry about. Inflammation tends to resolve fully with excellent results.

Curettage and cautery

Curettage and cautery is a minor procedure, where the lesion is skimmed off the skin and cauterised, resulting in a scab. I use a local anaesthetic to numb the area first.

Photodynamic therapy (PDT)

In PDT, a nurse will first apply a special cream, Metvix, for 20-30 minutes. The affected cells take up the cream. These cells then become more sensitive to specific wavelengths of light. Conventional PDT is performed with a particular light source however this can be uncomfortable. More recently, we have introduced daylight PDT, which takes advantage of natural sunlight. Patients tolerate this option well.

“I heard that Bowen’s disease is pre-cancerous. Does this mean I’m going to develop skin cancer?”

Though, strictly speaking, we class Bowen’s disease as a pre-cancerous condition, the risk of this progressing to a skin cancer known as squamous cell carcinoma (SCC), is very low, around 3%.

In reality, we therefore often characterise Bowen’s disease as sun damage, as this is how we treat it.

“Do I need to have my Bowen’s disease treated?”

Even though patches of Bowen’s disease are often asymptomatic and the risk of progression to SCC is low, I recommend that you have your Bowen’s disease treated. Treatment usually is straightforward, and patients tolerate it well. It will also reduce the likelihood of an SCC arising from this area.

“Do I need to take any special precautions after treatment?”

Patches of Bowen’s disease generally heal well following treatment.

Having had Bowen’s disease means that your skin is susceptible to sun damage and therefore you may be at an increased risk of certain types of skin cancer. The primary consideration is to look after your skin in the sun by taking special sun precautions.

Additionally, it would help if you looked out for any signs of possible skin cancer. Look for any new, growing, painful or bleeding lumps, especially in sun-exposed sites. Your GP and dermatologist should assess suspicious skin lesions.

Affiliations and memberships

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Questions and answers

RELEVANT AND INFORMATIVE VIDEOS AND ARTICLES

How can you prevent itchy skin?

There are several ways that you can assist in preventing itchy skin like soaps and clothing. However, you should see a healthcare professional to find the underlying cause of itchy skin.

About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.

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