Cutaneous Bowen's disease. An analysis of 1001 cases according to age, sex, and site

Abstract

Background: There are no large studies of Bowen's disease that have analyzed its distribution according to age, sex, and site.

Objective: This study was performed primarily to determine whether there were significant sex and site differences in the distribution of Bowen's disease.

Methods: One thousand one skin biopsy specimens of Bowen's disease were analyzed according to age, sex, and site of origin.

Results: This study revealed that the most common site of Bowen's disease was the head and neck (440 lesions), whereas specimens from the lower limbs (298 lesions) and upper limbs (198 lesions) outnumbered specimens from the torso (65 lesions). Of 298 specimens from the lower limbs, 72.1% were from women; 79.3% of the 87 specimens from the scalp and ears were from men. Eighty percent of the 85 specimens of Bowen's disease from the cheeks were from women.

Conclusion: These results indicate that cutaneous Bowen's disease occurs mainly on sun-exposed sites. This is also supported by the predominance of Bowen's disease on the lower limbs in women and on the scalp and ears in men. The basis for the female predominance on the cheeks is unknown, but may reflect the increased vulnerability to sun damage of superficial vellus hair follicles that predominate on the cheeks in women. This finding may provide indirect support for the hypothesis that some forms of Bowen's disease have a follicular histogenesis.