Simple shaving combined with photodynamic therapy for refractory bowen disease

Bowen Disease (BD), also known as squamous cell carcinoma in situ, requires treatment to prevent progression to invasive cancer.. Photodynamic therapy (PDT) has been widely employed to treat BD. However, there are BD patients who undergo PDT but experience poor efficacy and recurrence. We have considered that for some, the reason is the depth of PDT penetrating tissue to be limited. Therefore, we combined simple shaving with PDT to treat 10 patients with a total of 44 advanced BD lesions. After local injection of anesthesia, the lesions were shaved once in situ, then a total of three PDT sessions were applied for each patient. At 12 weeks, all of BD lesions (100%) have shown complete clinical response. After more than 12 months follow-up, the RR was 0, and all lesions showed a good or excellent cosmetic outcome. The patient's symptoms were alleviated with improvement in the quality of life. For those with advanced BD, which are more than 3 cm in diameter, with unclear borders, ulcers, multiple occurrences and those that appear on the face and neck that are not suitable for extended resection by routine surgery, combined simple shaving with PDT is recommended.