Cutaneous squamous carcinoma in situ (Bowen's disease): treatment with Mohs micrographic surgery.

Abstract

Bowen's disease (BD), also known as squamous intraepidermal carcinoma, is a malignant skin tumor with a potential to progress to invasive carcinoma. We sought to report a large series of patients with BD treated with Mohs micrographic surgery (MMS). This prospective, multicenter, case series included all patients in Australia treated with MMS for BD, who were monitored by the Skin and Cancer Foundation between 1993 and 2002. There were 270 cases; the majority (93.4%) were located in the head and neck area. In 50.7% of cases it was a recurrent tumor. In 20% the tumor was initially misdiagnosed as basal cell carcinoma or squamous cell carcinoma. No cases with perineural invasion were diagnosed. There were 6 cases of recurrence (6.3%) of 95 patients who completed a 5-year follow-up period after MMS. The low 5-year recurrence rate of BD with MMS emphasizes the importance of margin-controlled excision, especially in the head and neck area where tissue preservation is essential.