Maladie de Bowen à localisations multiples: présentation clinique et approche thérapeutique

Abstract

The Bowen’s disease (MB), also known as squamous cell carcinoma in situ is a neoplastic skin disease that was clinically and histologically individualized by Darier in 1914. The isolated lesions in the majority of patients can be multiplied in 10 to 20% of cases. We report many locations which has posed problems of therapeutic choice. It is the case of a 35-year-old housewife, seen in consultation for red colored and squamous patches associated to pruritus and pain. On the skin, the examination found red colored and squamous patches, in projection, shaped rounded with a very slow evolution combining in a variable manner, rashes, scales, crusts and keratosis. Patches tended to grow progressively. The vulvar lesions were pigmented patches. In the mouth, we noted ulcers and a diffuse hypopigmentation with cheilitis, perlèche and odynophagia. The oncology checkup in search of another skin, mucosal and visceral cancer was done without any cancer found and the general condition was retained. The histopathology performed on two biopsies confirmed the diagnosis. Considering the spread of lesions and after a pretreatment evaluation, we put the patient under 5fluorouracil in cream on evening and under isotretinoin capsule with favorable evolution in the third week. The multiple sites of MB are rare but pose a management problem because of the evolutionary potential of each individual lesion in squamous cell carcinoma. The choice of treatment depends on the general condition of the patient, the expected efficacy of the treatment but also on its tolerance and cost.

Keywords

• Bowen’s disease; Multiple locations; Symptoms