What are premalignant lesions of the epidermis?

Updated: Oct 07, 2019
  • Author: Guy J Petruzzelli, MD, PhD, MBA, FACS; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Bowen disease (Bowen precancerous dermatosis) is a common cutaneous process that has invasive potential and can be considered SCC in situ. Patients with Bowen disease possess atypical cells throughout the entire thickness of the epidermis.

Actinic keratosis (solar keratosis), while possessing atypical cells that do not extend to the full thickness of the epidermis, are best considered a form of precancerous lesion, as only 2-5% will progress to become SCC or Bowen disease. Occurring predominantly on sun-exposed skin, actinic keratoses can present as solitary or multiple lesions and are often described as hyperkeratotic scaly macules or papules. Bowen disease predominantly arises in the lower limbs and is characterized by a slow-growing, scaly plaque that often resembles patches of dermatitis or psoriasis.

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