Treatment of Bowen's Disease (SCC in Situ) in Immunosuppressed Patients
Bowen's disease presenting as squamous cell carcinoma in situ (SCC in situ) requires careful management in immunosuppressed individuals, where the clinical picture is often complicated by multiple or frequently recurring lesions.
Clinical Scenario
This protocol applies to patients with SCC in situ in the setting of immunosuppression. Immunosuppressed individuals face a heightened risk of multiple and recurring lesions, and treatment selection must account for this context.
Treatment Approach
Several first-line options exist, spanning topical therapy and procedural interventions. The full protocol specifies which approaches to consider for immunosuppressed patients and under what circumstances — the complete guidance is available via the link below.
Clinical Goal
Complete clearance of the SCC in situ lesion within 6 months.
References
DOI: 10.1093/bjd/ljac042
- Consider topical 5-fluorouracil (5%) in immunosuppressed people with SCC in situ, as a practical treatment for multiple and recurring lesions.
- Consider conventional, red-light PDT in immunosuppressed people with SCC in situ, as an effective, well-tolerated and repeatable treatment for multiple and frequently recurring lesions.
- Consider cryotherapy as a treatment option for immunosuppressed people with SCC in situ.
- Consider curettage with cautery as a treatment option for immunosuppressed people with SCC in situ.
- Consider standard surgical excision as a treatment option for immunosuppressed people with SCC in situ.
- For immunosuppressed people, reserve radiotherapy for where the SCC in situ has progressed to invasive disease.
- Clearance (within 6 months).