Bowen’s disease with multiple locations: Clinical presentation and therapeutic approach

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Résumé

The Bowen’s disease (MB), also known as squamous cell carcinoma in situ is a neoplastic skin disease that was clinically
and histologically individualized by Darier in 1914. The isolated lesions in the majority of patients can be multiplied
in 10 to 20% of cases. We report many locations which has posed problems of therapeutic choice. It is the case of a
35-year-old housewife, seen in consultation for red colored and squamous patches associated to pruritus and pain. On
the skin, the examination found red colored and squamous patches, in projection, shaped rounded with a very slow
evolution combining in a variable manner, rashes, scales, crusts and keratosis. Patches tended to grow progressively.
The vulvar lesions were pigmented patches. In the mouth, we noted ulcers and a diffuse hypopigmentation with
cheilitis, perlèche and odynophagia. The oncology checkup in search of another skin, mucosal and visceral cancer
was done without any cancer found and the general condition was retained. The histopathology performed on two
biopsies confirmed the diagnosis. Considering the spread of lesions and after a pretreatment evaluation, we put the
patient under 5fluorouracil in cream on evening and under isotretinoin capsule with favorable evolution in the third
week. The multiple sites of MB are rare but pose a management problem because of the evolutionary potential of
each individual lesion in squamous cell carcinoma. The choice of treatment depends on the general condition of the
patient, the expected efficacy of the treatment but also on its tolerance and cost

Mots-clés

Bowen’s disease; Multiple locations; Symptoms; Treatment; Burkina faso