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Bowen's disease and 5-fluorouracil.

H M Sturm

    Journal of the American Academy of Dermatology
    |December 1, 1979
    PubMed
    Summary

    Topical 5-fluorouracil (5-FU) offers a viable treatment for Bowen's disease, a form of intraepidermal squamous cell carcinoma. While recurrences can occur, prolonged 5-FU treatment demonstrates high success rates, especially for recalcitrant cases.

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    Area of Science:

    • Dermatology
    • Oncology

    Background:

    • Bowen's disease, or intraepidermal squamous cell carcinoma, presents diagnostic and therapeutic challenges due to ill-defined margins and follicular involvement.
    • Recurrence rates vary significantly across different treatment modalities for Bowen's disease.

    Purpose of the Study:

    • To evaluate the efficacy and recurrence rates of various treatment modalities for Bowen's disease.
    • To assess the effectiveness of topical 5-fluorouracil (5-FU) in treating Bowen's disease, including retreatment strategies.

    Main Methods:

    • Retrospective analysis of 66 confirmed cases of Bowen's disease treated between 1965 and 1976.
    • Comparison of treatment outcomes for surgical interventions (excision, desiccation and curettage), x-ray radiation, and topical 5-fluorouracil (5-FU).
    • Detailed examination of recurrence rates and successful retreatment protocols, particularly for 5-FU.

    Main Results:

    • Surgical treatments resulted in a 25% recurrence rate.
    • Topical 5-FU treatment showed an 8% recurrence rate.
    • All three recurrences after 5-FU treatment were successfully retreated with 5-FU, often requiring prolonged application (median 9 weeks).
    • 5-FU concentrations of 1% were effective on the face, while 2.5%-3.0% were needed for other body areas.

    Conclusions:

    • Topical 5-FU is an effective treatment for Bowen's disease, with a lower recurrence rate compared to surgery in this study.
    • Prolonged treatment duration and appropriate concentration of 5-FU are crucial for successful outcomes, especially in difficult-to-treat areas.
    • 5-FU serves as a viable option for both initial treatment and retreatment of Bowen's disease recurrences.

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