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Multiple‐digit periungual Bowen's disease: a novel treatment approach with radiotherapy
Authors:W. T. Hunt  A. Cameron  P. Craig  D. A. de Berker
Affiliation:1. Peninsula College of Medicine and Dentistry, Royal Devon and Exeter Hospital, , Exeter, UK and;2. Oncology Department, University Hospitals Bristol, , Bristol, Aron, UK;3. Histopathology Department, University Hospitals Bristol, , Bristol, Aron, UK;4. Bristol Dermatology Centre, University Hospitals Bristol, , Bristol, Aron, UK
Abstract:Multiple periungual Bowen disease [BD; also known as squamous cell carcinoma (SCC) in situ] is rare. The pathogenesis of the disease is linked to human papilloma virus, and in some instances to chronic immunosuppression. The usual management of periungual BD is by local excision, Mohs micrographic surgery or distal phalanx amputation. Our patient was offered radiotherapy in the hope of maximizing residual function and minimizing morbidity from treatment. A good response was seen at 2 months post‐radiotherapy, but this was followed by relapses at 4 and 6 months post‐radiotherapy. Persistent anonychia resulted in improved access to the involved skin, making topical therapy possible. Radiotherapy can be a valuable management approach for periungual SCC/BD in locations where amputation could result in substantial disability.
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