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S. A. Dawe, J. R. Salisbury, E. Higgins, Two cases of Bowen's disease successfully treated topically with 3% diclofenac in 2.5% hyaluronan gel, Clinical and Experimental Dermatology, Volume 30, Issue 6, 1 November 2005, Pages 712–713, https://doi.org/10.1111/j.1365-2230.2005.01867.x
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Conflict of interest: none declared.
Bowen's disease represents a form of squamous cell carcinoma in situ, which, if left untreated, progresses to invasive squamous cell carcinoma in 3–5% of patients.1 A preparation of 3% diclofenac in 2.5% hyaluronan gel (diclofenac HA gel; Solaraze®; Shire Pharmaceuticals) has been shown to be efficacious and well tolerated in actinic keratosis.2 We were interested to see if this preparation had any application in the treatment of Bowen's disease.
A 66‐year‐old man (patient 1) presented with a 5‐year itchy erythematous plaque on his left upper arm (Fig. 1a). A biopsy confirmed Bowen's disease with full‐thickness dysplasia (Fig. 2a). The patient was treated with diclofenac HA gel applied twice daily for 90 days. However, after 80 days he developed a severe dermatitis at the application site that necessitated discontinuation of the preparation. Clinical examination 4 weeks later revealed no evidence of recurrence (Fig. 1b). A biopsy showed mild inflammation and scar tissue, but no dysplasia (Fig. 2b). He has now been followed up for 10 months and remains clinically free of disease.
