Bowen's disease
ICD-10 D04.9 · ICD-11 2E64.00

Bowen's Disease with Multiple Lower-Leg Lesions in Poor General Health

This clinical scenario addresses squamous cell carcinoma in situ (Bowen's disease) presenting as multiple skin lesions, particularly concentrated on the lower legs, in a patient with poor general health.

Clinical scenario: Multiple SCC in situ lesions on the lower legs carry a greater risk of long-term ulceration following aggressive treatment. When a patient's general health is poor, this risk profile directly shapes the choice of management approach.
Approach: In this setting, conservative skin-directed measures are considered appropriate — the complete regimen specifies which interventions are indicated and the role of ongoing surveillance.
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References

DOI: 10.1093/bjd/ljac042

Consider conservative measures in people in poor health and with multiple SCC in situ lesions, especially on the lower legs, where there is a greater risk of long-term ulceration after treatment. This includes a moisturizer (preferably urea based) and skin surveillance, proceeding to biopsy if SCC is suspected.

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