A disease that’s linked to the sun—but also, HPV
The development of Bowen’s disease has been linked to sunlight exposure, human papilloma virus (HPV), and chronic arsenic intoxication.7
Sunlight exposure. Cumulative ultraviolet sunlight exposure is one of the most important etiologic factors. There is a doubling in the incidence of SCC for every 8- to 10-degree decrease in latitude.8
HPV. Human papillomavirus is common in patients who have SCCs in their genital areas.9 There is a poor correlation between nonanogenital Bowen’s disease and HPV infection. However, HPV types 2, 16, 18, 34, and 35 are occasionally identified in these lesions.10
Patients with penile Bowen’s disease (referred to as erythroplasia of Queyrat) are typically uncircumcised men with red, velvety plaques on the glans penis. Occasional itching and bleeding may be associated symptoms.
Arsenic intoxication. Chronic arsenic poisoning from drinking water is a documented cause of cancers occurring in the lung, bladder, kidney, liver, and skin. The US Geological Survey found the highest arsenic contamination levels of ground-water in the West, Midwest, and North-east United States.11
Unlike non-arsenical Bowen’s disease, arsenic-induced Bowen’s disease (As-BD) can occur on non-sun-exposed skin. As-BD typically appears 10 years after initial arsenic exposure, with pulmonary carcinoma appearing 30 years after exposure. As a result, it’s advisable to screen all patients with As-BD for cancer of the lung and bladder.12