Bowen’s Disease (Squamous Cell Carcinoma In Situ)

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Serving Hamilton, Stoney Creek, Grimsby and surrounding areas
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Bowen’s Disease:

Is usually a crusted, scaly, pink patch
May be as small as a 2 to 3 mm and as large as 20 cm or more across
Is usually present on sun exposed areas such as the ears, nose, face and tops of the hands
Is caused by the sun exposure that occurred 10 to 70 years before the spots appear
Is a low grade form of skin cancer caused by the sun
Spreads internally extremely rarely
Is a superficial form of squamous cell carcinoma, which affects only the uppermost layer of the skin

Prevention of bowen’s disease, and other skin cancers:

Wear a hat with a broad brim and protective clothing (e.g. long sleeves)
Avoid the outdoors when the sun is strongest between the hours of 10 am to 3 pm
Use a sunscreen year round with an SPF of at least 30
Wear a sunscreen which resists water and sweating and which protects against both UVA and UVB
Reapply sunscreen every hour if you are in water or sweating heavily
Wear sunscreen even if you are in the shade, it is still possible to burn
Avoid tanning beds
- The ultraviolet light tanning beds produce is known to cause skin cancer

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Liquid Nitrogen:

Is a cold freezing spray that is applied in the office
It causes the spots to become red, swollen and crusted
The spots will heal within 7 to 14 days
You can bathe or shower normally
The treated areas do not need to be covered by bandages

Creams:

A variety of creams are available
Please talk to your doctor about your options

Levulan Photodynamic Therapy (ALA PDT):

This treatment combines a medication called Levulan with either
- Blue Light or
- IPL (Intense Pulsed Light) treatments
Levulan PDT may be used to treat pre-cancerous sun spots, bowen’s disease, disseminated superficial actinic porokeratosis (DSAP), or acne

What are the advantages of Levulan PDT compared with other treatments?:

Unlike creams it has the advantage of being able to treat large areas in a single visit
Unlike liquid nitrogen, the treatment is not painful
It treats precancerous spots before they can be seen
- Preventing skin cancer from developing

Levulan-IPL Photodynamic Therapy:

Non-invasive and effective
Used to treat acne, actinic keratoses (prec-cancerous sun spots), Disseminated Superficial Actinic Porokeratosis (DSAP), bowen’s disease, superficial basal cell carcinomas, as well as sun-damaged skin
Acts by killing acne causing bacteria, overactive oil glands and premalignant skin cells and precancers

Almost any area can be treated including:
- Face and neck
- Arms and hands
- Feet and legs
- Chest and back
- Scalp

The Levulan-IPL PDT treatment works with most skin types (I-IV) (from pale Caucasian to dark European and very light Asian)

Levulan-IPL PDT cannot be used for darker skin types (V, VI) (South Asian, African) or if you have a tan
- In this situation I recommend Blue Light PDT instead, which:
  - Can be used in all skin types
  - Can be used even if the skin is tanned
  - To learn more about Blue Light PDT, please click here

As an added bonus, Levulan PDT also treats:
- Brown freckling
- Enlarged pores
- Sun damage
- Depleted skin collagen

All of these lead to smoother, younger looking skin and reduced redness at the same time

The cost of Levulan PDT is partially covered on most private drug insurance plans
The cost of Levulan PDT is not covered on the Ontario ODSP (OHIP) drug plan for patients over 65 years of age

If you would like to learn more about Levulan PDT for the treatment of bowen’s disease, and skin cancer prevention, please click here

Electrodessication and Curettage:

The skin around the bowen’s disease is injected with a local anesthetic to numb the area
The injection stings for a few seconds
- After this, there is no pain or discomfort
The bowen’s disease is removed from the skin in a scraping motion with an instrument called a curette
As the area is numb from the anesthetic, this process is not painful
The curetted area is then treated with electrocautery, a hot electric needle
- This is not painful as the area is still numb
Electrocautery stops and bleeding and kills any residual cancer cells
The lesion is scraped and cauterized a total of 3 times in one visit
No stitches are required
Antibiotic and a bandage are used to cover the wound
The day after surgery, the bandage should be removed and a small amount of antibiotic should be be applied
- This should occur twice daily site is healed
Redness, pain, swelling or a discharge from the wound may be a sign of infection
- The doctor should be informed immediately
You may bathe, shower and do your normal activities unless the bowen’s disease that has been removed is very large and there is a risk of the wound being damaged
- The doctor will inform you about this
There is a small chance that the bowen’s disease could grow back

Surgical Excision:

The skin around the bowen’s disease is injected with a local anesthetic to numb the area
The injection stings for a few seconds
- After this, there is no pain or discomfort
The bowen’s disease and a small amount of surrounding normal skin is cut with a scalpel and removed
As the area is numb from the anesthetic, this process is not painful
Stitches are used to close the opening
Antibiotic and a bandage are used to cover the wound
The day after surgery, the bandage should be removed and a small amount of antibiotic should be be applied
- This should occur twice daily until the stitches are removed
Redness, pain, swelling or a discharge from the wound may be a sign of infection
- The doctor should be informed immediately
The stitches are removed in 5 to 10 days
The removal of stitches is painless
You may bathe, shower and do your normal activities unless the bowen’s disease that has been removed is very large and there is a risk of the wound being damaged
- The doctor will inform you about this
There is a small chance that the bowen’s disease could grow back

Would you like to see a Video Demonstration?

I am pleased to offer a new section on the website with video demonstrations of various procedures
To watch a video-clip in which Dr. V talks about:

Levulan PDT Treatments, please click here

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Cherry Hemangioma – Eye Brow
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