| Theme |
Diagnosis and Treatment of Anorectal Disease |
| Title |
Perianal Bowen's Diseaset |
| Author |
Naoki Inatsugi |
Kenseikai Nara Coloproctology Center |
| Author |
Shusaku Yoshikawa |
Kenseikai Nara Coloproctology Center |
| Author |
Takashi Yokoo |
Kenseikai Nara Coloproctology Center |
| Author |
Tsuyoshi Ueda |
Department of Surgery, Nara Medical University School of Medicine |
| Author |
Shousuke Nakajima |
Department of Surgery, Nara Medical University School of Medicine |
| Author |
Yasunori Enomoto |
Department of Pathology, Nara Medical University School of Medicine |
| [ Summary ] |
Bowen's disease is a form of squamous cell carcinoma in situ, derived from keratinocytes. Most authors at the present time regard only high-grade anal intraepithelial neoplasia (AIN) as being a form of Bowen's disease, which is primarily caused by human papilloma virus (HPV)-16 and -18. Bowen's disease occurs more often in adults over 50 and most commonly in the torso. It is rarely seen in the perianal region. Patients may complain of wetness, itching, discomfort, burning, feeling lumps in the perianal region or bleeding during bowel movements. However, some patients remain asymptomatic and symptoms often resemble those associated with chronic eczema. Only a biopsy will confirm a diagnosis. Histopathologically, atypical squamous cells proliferate through the whole thickness of the epidermis. Clumping cells and dyskeratotic cells may also be observed. Bowenʼs disease is treated with local therapy (application of ointment), ablation, radiation and cryotherapy. The most curative treatment is excision. |