Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Apr 3;12(4):795.
doi: 10.3390/biomedicines12040795.

Photodynamic Therapy for the Treatment of Bowen's Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

Paolo Antonetti  1   2 , Cristina Pellegrini  1   2 , Chiara Caponio  2 , Manfredo Bruni  1   2 , Lorenzo Dragone  1   2 , Mirco Mastrangelo  1 , Maria Esposito  1   2 , Maria Concetta Fargnoli  1   2
Affiliations
Review

Photodynamic Therapy for the Treatment of Bowen's Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

Paolo Antonetti et al. Biomedicines. .

Abstract

Bowen's disease represents the in situ form of cutaneous squamous cell carcinoma; although it has an excellent prognosis, 3-5% of lesions progress to invasive cutaneous squamous cell carcinoma, with a higher risk in immunocompromised patients. Treatment is therefore always necessary, and conventional photodynamic therapy is a first-line option. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen's disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Photodynamic therapy is a valuable option for tumors at sites where wound healing is poor/delayed, in the case of multiple and/or large tumors, and where surgery would be difficult or invasive. Dermoscopy and reflectance confocal microscopy can be used as valuable tools for monitoring the therapeutic response. The treatment is generally well tolerated, with mild side effects, and is associated with a good/excellent cosmetic outcome. Periodic follow-up after photodynamic therapy is essential because of the risk of recurrence and progression to cSCC. As the incidence of keratinocyte tumors increases, the therapeutic space for photodynamic therapy will further increase.

Keywords: ALA-PDT; Bowen’s disease; MAL-PDT; immunocompromised patients; non-melanoma skin cancer; photodynamic therapy; squamous cell carcinoma in situ.

PubMed Disclaimer

Conflict of interest statement

M.C.F. has served on advisory boards, received honoraria for lectures and/or research grants from AMGEN, Almirall, Abbvie, Boehringer-Ingelheim, BMS, Galderma, Kyowa Kyrin, Leo Pharma, Pierre Fabre, UCB, Lilly, Pfizer, Janssen, MSD, Novartis, Sanofi-Regeneron, and Sunpharma. M.E. has served as a speaker/board member for Abbvie, Almirall, Biogen, Celgene, Eli Lilly, Janssen, Leo Pharma, and Novartis. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Clinical, dermoscopic, and confocal images of Bowen’s disease: (A) erythematous, scaly, well-demarcated plaque; (B) glomerular vessels and scaly surface on an erythematous base (10×); and (C) tightly coiled vessels, some with an S-shape, in the center of dermal papillae; hyper-reflective stroma (mosaic, 8 × 8 mm).
Figure 2
Figure 2
Treatment of Bowen’s disease with MAL-PDT. (A) BD lesion on the scalp in a 76-year-old OTR patient before and after two sessions of MAL-PDT, 1 week apart; (B) A 64-year-old female patient with a BD tumor on the temporal region before and after MAL-PDT treatment.
Figure 3
Figure 3
Dermoscopic monitoring (10×) of treatment response. Bowen’s disease in an 89-year-old patient on the retro-auricular area before (A–C) and after two sessions of MAL-PDT (B,D).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bowen J.T. Precancerous dermatoses: A study of two cases of chronic atypical epithelial proliferation. J. Cutan. Dis. 1912;30:241–255. doi: 10.1001/archderm.1983.01650270061020. - DOI - PubMed
    1. Callen J.P. Bowen’s disease and internal malignant disease. Arch. Dermatol. 1988;124:675–676. doi: 10.1001/archderm.1988.01670050019010. - DOI - PubMed
    1. Arlette J.P., Trotter M.J. Squamous cell carcinoma in situ of the skin: History, presentation, biology and treatment. Australas. J. Dermatol. 2004;45:1–11. doi: 10.1111/j.1440-0960.2004.00025.x. - DOI - PubMed
    1. Reizner G.T., Chuang T.Y., Elpern D.J., Stone J.L., Farmer E.R. Bowen’s disease (squamous cell carcinoma in situ) in Kauai, Hawaii. A population-based incidence report. J. Am. Acad. Dermatol. 1994;31:596–600. doi: 10.1016/S0190-9622(94)70222-5. - DOI - PubMed
    1. Moloney F.J., Comber H., O’Lorcain P., O’Kelly P., Conlon P.J., Murphy G.M. A population-based study of skin cancer incidence and prevalence in renal transplant recipients. Br. J. Dermatol. 2006;154:498–504. doi: 10.1111/j.1365-2133.2005.07021.x. - DOI - PubMed