Bowen's Disease

Bowen 病
  • 文章类型: Journal Article
    角质形成细胞衍生的皮肤癌包括基底细胞癌,鳞状细胞癌,它的前驱光化性角化病,和Bowen的病.历史上,这类肿瘤被归入非黑素瘤皮肤癌。然而,“非黑色素瘤皮肤癌”一词可能具有误导性,并且缺乏准确性。因此,更精确和合理的术语,评估角质形成细胞衍生癌症的相关性,似乎符合其临床和科学意义。一组经验丰富的皮肤肿瘤学家提出了一种共识方法,以促进使用术语“角质形成细胞癌”而不是“非黑色素瘤皮肤癌”。共识小组成员之间的投票表明,一致同意始终使用“角质形成细胞癌”一词而不是“非黑色素瘤皮肤癌”。国际代表也投票赞成修订后的术语。越精确,通过病因,正确的术语“角质形成细胞癌”应始终用于源自角质形成细胞的恶性肿瘤。预计这将对患者-医师沟通产生积极影响,并为这一重要的角质形成细胞衍生癌症组提供更好的正义。
    Keratinocyte-derived skin cancers comprise basal cell carcinoma, squamous cell carcinoma, its precursor actinic keratosis, and Bowen\'s disease. Historically, this group of neoplasms has been subsumed under the term non-melanoma skin cancer. However, the term non-melanoma skin cancer can be misleading and lacks precision. Therefore, more precise and reasonable terminology, valuing the relevance of keratinocyte-derived cancer, appears pertinent to meet its clinical and scientific significance. A group of experienced dermato-oncologists initiated a consensus approach to promote the use of the term \"keratinocyte cancer\" instead of \"non-melanoma skin cancer\" when referring to carcinomas and their precursors that are derived from keratinocytes. The vote among members of the consensus group indicated unanimous agreement on the consistent use of the term \"keratinocyte cancer\" instead of \"non-melanoma skin cancer\". International delegates also voted in favour of the revised terminology. The more precise and, by means of etiopathogenesis, correct term \"keratinocyte cancer\" should be consistently used for malignancies originated from keratinocytes. This is expected to have a positive impact on patient-physician communication and gives better justice to this important group of keratinocyte-derived cancers.
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  • 文章类型: Journal Article
    Bowen病(BD)是一种相对罕见的早期鳞状细胞原位癌,最常见的影响中老年人,并发生在身体各个部位的皮肤或粘膜上。它的发作是隐蔽的,这种疾病是慢性的,有些病人皮肤外有恶性肿瘤;因此,有必要在早期诊断和评估疾病。本研究旨在探讨反射共聚焦显微镜(RCM)在BD诊断中的应用。我们对病变部位进行了RCM成像,并进行了皮肤活检,以对92例最初在临床上诊断为BD的患者进行组织学诊断。对RCM结果以及组织学检查的回顾性分析显示,在分析RCM图像后,在92个活检病灶中,61人被诊断为BD,其中54例与RCM诊断一致。在RCM诊断为BD的59例中,54例符合组织学诊断。之后,我们分析了通过活检证实的BD患者的RCM特征,并比较了两种不同病变的RCM图像,经典Bowen病和色素性Bowen病,并进一步总结了BD在RCM下的应用要点。最后,我们重点研究了BD与RCM中其他皮肤病的差异特征。RCM对BD的诊断具有重要价值。研究重点:临床诊断为BD患者的RCM和组织学诊断的回顾性研究。分析活检证实的皮肤病变的RCM特征。RCM对BD的诊断和鉴别诊断具有重要价值。
    Bowen\'s disease (BD) is a relatively rare early-stage squamous cell carcinoma in situ, most commonly affecting the middle-aged and elderly, and occurring on the skin or mucous membranes of various parts of the body. Its onset is concealed, the course of the disease is chronic, and some patients have malignant tumors outside the skin; therefore, it is necessary to diagnose and evaluate the disease at an early stage. This study aimed to investigate the application of reflectance confocal microscopy (RCM) in the diagnosis of BD. We performed RCM imaging on the lesion site and underwent skin biopsy for histological diagnosis of 92 patients initially diagnosed with BD in clinic. A retrospective analysis of the RCM result as well as the histological examination revealed that after analyzing RCM images, out of 92 biopsy lesions, 61 were diagnosed with BD, of which 54 were consistent with RCM diagnosis. Among the 59 cases diagnosed with BD by RCM, 54 cases were consistent with the histological diagnosis. Afterwards, we analyzed the RCM characteristics in patients with BD verified by biopsy, and compared the RCM images of two different lesions, classic Bowen\'s disease and pigmented Bowen\'s disease, and further summarized the key points of BD under RCM. Finally, we focused on the differential characteristics between BD and other skin diseases in RCM. RCM is of great value in the diagnosis of BD. RESEARCH HIGHLIGHTS: A retrospective study of RCM and histological diagnosis in patients with clinical diagnosis of BD. Analyze the RCM characteristics of skin lesions verified by biopsy. RCM is of great value in the diagnosis and differentiation of BD.
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  • 文章类型: Letter
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  • 文章类型: Case Reports
    背景:Bowen病(BD)代表一种原位鳞状细胞癌,无需治疗即可发展为浸润性鳞状细胞癌。已经描述了鲍恩病的各种选择,每一个都有它的优点和缺点。
    方法:我们报告了一例60岁患者,有慢性吸烟史,有多个伴侣和复发性尿道炎的背景。患者表现为阴茎外侧有斑丘疹性病变,进化了5年。活检证实了Bowen病的诊断。该患者接受了病变切除,组织学显示为浸润性基底鳞状细胞癌。
    结论:Bowen病的诊断需要活检和组织学检查。只有手术治疗才能进行鉴定,通过对切除标本的组织学分析,活检中可能未发现的任何潜在侵入性区域。非手术疗法也是一种高复发率的选择。
    结论:Bowen的疾病管理需要个性化的方法,考虑到病变特征等因素,患者相关变量和治疗效果。由于与各种治疗相关的复发风险,建议进行适应性随访。
    BACKGROUND: Bowen\'s disease (BD) represents an in situ squamous cell carcinoma that can progress to an invasive one without treatment. Various options for Bowen\'s disease have been delineated, each with its set of advantages and disadvantages.
    METHODS: We report the case of a 60-year-old patient with a history of chronic smoking and a background of multiple partners and recurrent urethritis. The patient presented with a maculopapular lesion on the lateral aspect of the penis, evolving for 5 years. A biopsy confirmed the diagnosis of Bowen\'s disease. The patient underwent an excision of the lesion which the histology showed an infiltrating basosquamous cell carcinoma.
    CONCLUSIONS: The diagnosis of Bowen\'s disease requires a biopsy and is based on histological examination. Only surgical treatment allows for the identification, through histological analysis of the excised specimen, of any potential invasive area that may not have been identified in the biopsy. Nonsurgical therapies are also an option with high recurrence rates.
    CONCLUSIONS: Bowen\'s disease management requires a personalized approach, considering factors like lesion characteristics, patient-related variables and treatment efficacy. An adapted follow-up is recommended due to the recurrence risk associated with various treatments.
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  • 文章类型: Journal Article
    目的:默克尔细胞癌(MCC)是一种罕见的皮肤神经内分泌肿瘤,主要发生在65岁以上白人患者的阳光照射部位,具有较高的复发率和转移率。临床上,MCC重叠鲍恩氏病(BD)是一种非常罕见的MCC亚型。文献中很少描述案例,管理也没有很好的定义。我们总结和更新流行病学,临床和组织病理学特征,转移特征,通过介绍两例MCC重叠BD并回顾过去11年的文献,介绍了局部复发率和治疗方法。
    方法:我们查阅了PubMed的数据库,研究门和谷歌学者由MeSh“默克尔细胞癌”和“鲍恩病”,\"Bowen病\"或\"鳞状细胞原位癌\",2013年1月至2023年12月,对文献进行了综述。我们报告了另外两个病例。
    结果:对13例MCC重叠BD进行回顾性分析,其中主要是70岁以上的老年妇女,皮肤损伤主要发生在面部,其次是四肢和躯干。他们大多数无症状,公司,在快速生长的红色或深棕色斑块上出现的暗红色结节,或表现为孤立的结节。术前诊断设置很少进行皮肤镜检查评估。所有病例均经组织病理学和免疫组化证实。最明确的治疗方法是扩大局部切除,但局部复发很常见。在13个案例中,4例出现局部或远处转移。一名患者在局部切除和淋巴结清扫后同侧腿MCC在途复发,其转移在avelumab治疗后完全消退,在6个月的随访中没有复发或转移。
    结论:MCC重叠BD是一种非常罕见的皮肤肿瘤,主要倾向于面部,误诊率和复发率高。诊断时的晚期疾病是预后不良的因素,这表明早期检测可能会改善结果。缩写,AEIOUN,已被提议帮助临床鉴定。我们的报告和文献综述可以提供更好的认识和管理。
    OBJECTIVE: Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin, which mainly occurs in the sun exposed sites of white patients over 65 years, with a higher recurrence and metastasis rate. Clinically, MCC overlapping Bowen\'s disease (BD) is a very rare subtype of MCC. Few cases in the literature have been described and the management is not well defined. We summarize and update the epidemiology, clinical and histopathological features, metastasis characteristics, local recurrence rate and management of it by presenting two cases of MCC overlapping BD and reviewing the literature over the last 11 years.
    METHODS: We consulted databases from PubMed, ResearchGate and Google Scholar by MeSh \"Merkel cell carcinoma\" and \"Bowen\'s disease\", \"Bowen disease\" or \"squamous cell carcinoma in situ\", from January 2013 to December 2023 and reviewed the literatures. We reported two additional cases.
    RESULTS: Total 13 cases of MCC overlapping BD were retrospectively analyzed, in whom mainly in elderly women over 70 years, the skin lesions were primarily located on the faces, followed by the extremities and trunk. Most of them were asymptomatic, firm, dark red nodules arising on rapidly growing red or dark brown patches, or presenting as isolated nodules. Dermoscopy evaluation was rarely performed in the pre-operative diagnostic setting. All cases were confirmed by histopathology and immunohistochemistry. The most definitive treatment was extended local excision, but local recurrences were common. Of the 13 cases, 4 cases experienced local or distant metastasis. One suffered from an in-transit recurrence of MCC on the ipsilateral leg after local excision and lymph node dissection, whose metastasis completely subsided after avelumab treatment and without recurrence or metastasis during 6 months of follow-up.
    CONCLUSIONS: MCC overlapping BD is a very rare skin tumor mainly predisposed on the faces, with high misdiagnosis rate and recurrence rate. Advanced disease at diagnosis is a poor prognostic factor, suggesting that earlier detection may improve outcome. The acronym, AEIOUN, has been proposed to aid in clinical identification. Our reports and the literature review can provide a better awareness and management of it.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    皮肤鳞状细胞癌(CSCC)是第二常见的皮肤癌类型,在基底细胞癌之后,约占所有恶性皮肤肿瘤的10-20%。CSCC的死亡率接近肾癌和口咽癌,以及黑色素瘤,随着一旦发生转移和神经周浸润的风险增加。光化性角化病(AK)和Bowen病(BD)都是有可能发展为CSCC的直接前兆。在这项研究中,我们分析了Ki67,P16和β-catenin在CSCC前体病变中的表达与组织学预后参数的关系,分别在它们之间,目的是确定与预后作用的可能相关性。Ki67和P16在晚期癌前病变中得分较高,如角质形成细胞上皮内瘤变(KIN)III和BD,脂溢性角化病(SK)得分低。对所研究标记的免疫反应性证实了多阶段皮肤癌的发生,以及它们从癌症过程的起始阶段开始的参与。所研究的标志物在CSCC癌前病变的演变和预后中的重要性也得到了AK中P16,Ki67免疫表达与β-catenin膜免疫表达之间的线性相关的支持。
    Cutaneous squamous cell carcinoma (CSCC) is the second most common type of skin cancer, after basal cell carcinoma, representing about 10-20% of all malignant skin tumors. The mortality rates of CSCC approach those of renal and oropharyngeal carcinomas, as well as melanoma, with the increasing of the risk once metastases and perineural invasion occur. Both actinic keratosis (AK) and Bowen\'s disease (BD) are direct precursors with the potential for progression to CSCC. In this study, we analyzed the expression of Ki67, P16 and Beta-catenin in the precursor lesions of CSCC in relation to histological prognostic parameters, respectively between them, with the aim of identifying possible correlations with a role in prognosis. Ki67 and P16 presented higher scores in advanced precancerous lesions, such as keratinocyte intraepithelial neoplasia (KIN) III and BD and low scores in seborrheic keratosis (SK). The immunoreactivity to the investigated markers confirms the multistage skin carcinogenesis, and their involvement starting from the initiation phase of the cancer process. The importance of the studied markers in the evolution and prognosis of precancerous lesions of CSCC is also supported by the linear correlations revealed between the immunoexpressions of P16, Ki67 and the membranous immunoexpression of Beta-catenin in AK.
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  • 文章类型: Journal Article
    背景:流行病学证据表明饮用水中的砷与癌症发病率增加之间存在关联。这项基于人群的研究调查了台湾黑脚病流行地区安装自来水供水系统对癌症发病率的影响。
    方法:通过使用台湾癌症登记数据集,我们招募了40-84岁被诊断患有砷相关癌症的患者,包括肝细胞癌,小型鳞状细胞肺癌,Bowen病,基底和鳞状细胞皮肤癌,尿路上皮膀胱癌,1995年至2019年之间的上尿路上皮癌。随机效应年龄周期队列模型用于估计癌症发病率数据,并采用稳定的克里格方法将发生率插值为更精确的时空单位。
    结果:结果显示,1995年至2019年,黑脚病流行地区的所有六种癌症的年龄标准化发病率始终高于其他地区。然而,大约在1960年出生队列开始安装自来水供水系统后,黑脚病流行地区与其余地区之间的发病率差距开始缩小。对于小型鳞状细胞肺癌,Bowen病,和膀胱尿路上皮癌,砷缓解后出生的人群的超额发病率急剧下降,为零.对于上尿路上皮癌,砷缓解后出生的人的超额发病率逐渐下降。对于肝细胞癌和基底和鳞状细胞皮肤癌,超额发病率保持不变.在黑脚病流行地区的核心乡镇确定了高发病率的时空集群。这些集群主要在1960年出生队列之后开始消散。
    结论:台湾饮用水中的砷缓解与减轻小细胞肺癌和鳞状细胞肺癌的负担有关,Bowen病,尿路上皮膀胱癌,和上尿路上皮癌。
    BACKGROUND: Epidemiological evidence has demonstrated an association between arsenic in drinking water and increased cancer incidence. This population-based study investigates the impact of a tap water supply system installation in Blackfoot disease-endemic regions of Taiwan on cancer incidence.
    METHODS: By using the Taiwan Cancer Registry dataset, we enrolled patients aged 40-84 diagnosed with arsenic-related cancers, including hepatocellular carcinoma, small and squamous cell lung cancer, Bowen\'s disease, basal and squamous cell skin cancer, urothelial bladder cancer, and upper tract urothelial carcinoma between 1995 and 2019. Random-effects age-period-cohort models were used to estimate the cancer incidence data, and a stabilized kriging method was employed to interpolate incidence rates to more precise spatiotemporal units.
    RESULTS: The results showed that the age-standardized incidence rates of all six types of studied cancers were consistently higher in Blackfoot disease-endemic areas than those in other areas from 1995 to 2019. However, the gap in incidence rates between Blackfoot disease-endemic areas and the remaining regions began to narrow approximately after the 1960 birth cohort when the tap water supply system installation commenced. For small and squamous cell lung cancer, Bowen\'s disease, and urothelial bladder cancer, the excess incidence rates sharply declined to null for those born after the year of arsenic mitigation. For upper tract urothelial carcinoma, the excess incidence rates decreased more gradually for those born after the year of arsenic mitigation. For hepatocellular carcinoma and basal and squamous cell skin cancer, the excess incidence rates remained constant. Spatiotemporal clusters of high incidence rates were identified in the core townships of Blackfoot disease-endemic areas. These clusters began to dissipate mainly after the 1960 birth cohort.
    CONCLUSIONS: Arsenic mitigation from drinking water in Taiwan is associated with a reduced burden of small and squamous cell lung cancers, Bowen\'s disease, urothelial bladder cancer, and upper tract urothelial carcinoma.
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  • 文章类型: Case Reports
    光动力疗法(PDT)是一种非侵入性、有效治疗浅表皮肤状况,与传统疗法相比,提供优越的美容效果。乳头乳晕复合体(NAC)的Bowen病(BD)很少见,因此,缺乏标准化的治疗方法。本报告详细介绍了一名48岁妇女的情况,该妇女使用PDT成功治疗了NAC的BD。在30个月的随访期内,没有疾病复发的证据,强调了PDT作为这种罕见的BD表现的可行治疗选择的潜力。
    Photodynamic therapy (PDT) is a non-invasive, effective treatment for superficial skin conditions, offering superior cosmetic outcomes compared with traditional therapies. Bowen\'s disease (BD) of the nipple-areola complex (NAC) is rare and thus, lacks a standardized treatment approach. This report details the case of a 48-year-old woman who was successfully treated for BD of the NAC using PDT. Over a follow-up period of 30 months, there was no evidence of disease recurrence, underscoring the potential of PDT as a viable treatment option for this rare manifestation of BD.
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  • 文章类型: Case Reports
    Bowen病(BD)是以其稀有性和诊断复杂性而闻名的皮肤病学实体。虽然BD以其多样化的临床表现而闻名,它在肛周区域的发生尤为特殊。我们的案例有助于有限的知识关于肛周BD,阐明其独特的特征,并指导临床医生浏览与这种罕见的表现相关的复杂性。
    方法:我们介绍了一名67岁女性因肛周区域持续瘙痒而寻求医疗护理的病例。彻底检查发现有孤立的BD病变,在这个解剖部位非常罕见。考虑到独特的特点和位置,选择手术切除作为首选治疗策略.术后过程很简单,产生良好的美学结果,没有复发。
    临床讨论探讨了与肛周BD相关的独特挑战,强调其表现的稀有性及其模仿其他皮肤病的潜力。有助于诊断的因素,包括临床指标和危险因素,被仔细检查。此外,讨论深入探讨了诊断工具和治疗方式的不断发展的景观,尤其与肛周BD有关。
    结论:该病例说明了肛周区域BD的稀有性,作为对这个不寻常的演示文稿的有限知识体系的宝贵补充。通过解开与肛周BD相关的复杂性,本报告有助于更深入地了解该疾病,并提供了可以指导临床医生浏览类似病例的见解.
    UNASSIGNED: Bowen\'s Disease (BD) stands out as a dermatologic entity known for its rarity and diagnostic intricacies. While BD is recognized for its diverse clinical presentations, its occurrence in the perianal region is particularly exceptional. Our case contributes to the limited body of knowledge regarding perianal BD, shedding light on its distinctive characteristics and guiding clinicians in navigating the intricacies associated with this uncommon presentation.
    METHODS: We present the case of a 67-year-old female who sought medical attention for persistent itching in the perianal region. A thorough examination revealed a solitary BD lesion, a notable rarity in this anatomical site. Considering the distinctive characteristics and location, surgical excision was chosen as the preferred treatment strategy. The postoperative course was straightforward, yielding favorable aesthetic outcomes and no recurrence.
    UNASSIGNED: The clinical discussion explores the unique challenges associated with perianal BD, emphasizing the rarity of its presentation and its potential to mimic other dermatologic conditions. Factors contributing to the diagnosis, including clinical indicators and risk factors, are scrutinized. Furthermore, the discussion delves into the evolving landscape of diagnostic tools and treatment modalities, especially relevant in the context of perianal BD.
    CONCLUSIONS: This case illuminates the rarity of BD in the perianal region, serving as a valuable addition to the limited body of knowledge on this unusual presentation. By unraveling the complexities associated with perianal BD, this report contributes to a deeper understanding of the disease and provides insights that can guide clinicians in navigating similar cases.
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