Cutaneous squamous carcinoma in situ (Bowen's disease): treatment with Mohs micrographic surgery.

BACKGROUND: Bowen's disease (BD), also known as squamous intraepidermal carcinoma, is a malignant skin tumor with a potential to progress to invasive carcinoma.

OBJECTIVE: We sought to report a large series of patients with BD treated with Mohs micrographic surgery (MMS).

METHODS: This prospective, multicenter, case series included all patients in Australia treated with MMS for BD, who were monitored by the Skin and Cancer Foundation between 1993 and 2002.

RESULTS: There were 270 cases; the majority (93.4%) were located in the head and neck area. In 50.7% of cases it was a recurrent tumor. In 20% the tumor was initially misdiagnosed as basal cell carcinoma or squamous cell carcinoma. No cases with perineural invasion were diagnosed. There were 6 cases of recurrence (6.3%) of 95 patients who completed a 5-year follow-up period after MMS.

CONCLUSION: The low 5-year recurrence rate of BD with MMS emphasizes the importance of margin-controlled excision, especially in the head and neck area where tissue preservation is essential.