Periungual Bowen's disease successfully treated with photodynamic therapy

Bowen's disease or squamous cell carcinoma in situ is a malignancy of the skin confined to the epidermis that unusually involves the nail apparatus. The ideal treatment should complete clear the tumor, with preservation of the cosmetics and the function of the finger, which can be very difficult to achieve depending on tumor's location and the extension. The high cure rates for Bowen's disease and the principles of photodynamic therapy, suggest that this technique may be a great option in the management of this kind of lesion. Therefore, this is a case report of a 47-years-old man with diabetes and HIV+ serology who presented a patch of Bowen's disease at the distal phalange of the finger treated with photodynamic therapy in order to avoid surgical complications, a more aggressive treatment or even mutilation. An excellent response was reached, preserving all the structures of the nail, with clinical and histopathological cure and complete remission after two years of follow up.