Photodynamic Therapy for Bowen's Disease of the Vulva Area

Abstract

Bowen's disease is a squamous cell carcinoma in situ and has the potential to progress to a squamous cell carcinoma. The authors treated two female patients (a 39-year-old and a 41-year-old) with Bowen's disease in the vulva area using topical photodynamic therapy (PDT), involving the use of 5-aminolaevulinic acid and a light-emitting diode device. The light was administered at an intensity of 80 mW/cm(2) for a dose of 120 J/cm(2) biweekly for 6 cycles. The 39-year-old patient showed excellent clinical improvement, but the other patient achieved only a partial response. Even though one patient underwent a total excision 1 year later due to recurrence, both patients were satisfied with the cosmetic outcomes of this therapy and the partial improvement over time. The common side effect of PDT was a stinging sensation. PDT provides a relatively effective and useful alternative treatment for Bowen's disease in the vulva area.

Keywords: Bowen's disease; Photochemotherapy; Vulva area.

Fig. 1

(A) Erosive patches and verrucous papules with a pinkish center and a black-pigmented margin on the left labium minor. (B) After six sessions of photodynamic treatment.

Fig. 2

The cells lie in disorder with a windblown appearance in the epidermis (H&E, ×100).

Fig. 3

Erosive macerative patches and verrucous papules on both major labia.

Fig. 4

The histopathological specimen revealed pronounced acanthosis, hyperkeratosis and parakeratosis with atypical cells and mitosis in the epidermis (H&E, ×100).