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A Case of Bowen's Disease Successfully Treated by Photodynamic Therapy
Department of Cutaneous and Mucosal Pathophysiology, Graduate School of Medicine, Nippon Medical School
Photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) (ALA-PDT) is useful for treating nonmelanoma skin cancers, actinic keratosis and psoriasis, in addition to several other cutaneous indications1,2. In Bowen's disease in light skin types, ALA-PDT resolves an average of 86% to 93% of lesions following 1 or 2 treatments3. ALA-PDT is a particularly good option for unusual sites or poor healing lesions because of its good cosmetic and functional outcomes.
The patient in this case was a 56-year-old Japanese female with a 1.8 × 2.5 cm erythematous plaque with a thick crust on the right shin (Fig. 1a). A skin biopsy showed acanthosis and full-thickness atypia of the epidermis with hyperkeratosis and parakeratosis (Fig. 2a). The diagnosis was Bowen's disease, which is a form of carcinoma in situ. ALA-PDT was performed over a series of 5 treatments at 1-month intervals. After 4 hours contact with 20% ALA under occlusion, irradiation was applied with a broadband light source (600 to 1,100 nm, 90 J/cm2, 66 mW/cm2). Disappearance of malignant cells was confirmed 1 month after the last treatment (Fig. 2b) and there has been no recurrence and a good cosmetic outcome over a 3-year follow-up period (Fig. 1a-f).
J Nippon Med Sch 2010; 77: 136-137
Correspondence to
Sachiko Kosaka, Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
p-chan@nms.ac.jp
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