- Arsenic exposure: The literature supports an association between Bowen disease and arsenic exposure, often occurring after a time lag of 10 years. The main sources of arsenic exposure include Fowler solution, a medication formerly used to treat psoriasis; Gay solution, a medication formerly used to treat asthma; contaminated well water; and certain pesticides.
- Human papillomavirus: Human papillomavirus type 16 is by far the most common subtype isolated from lesions of Bowen disease, although other subtypes, such as HPV 2, 18, 31, 33, 54, 56, 61, 62, and 73 also have been found.
- Immunosuppression: Immunosuppressed patients with Bowen disease are more likely to have multiple tumors and more aggressive tumors.
- Other possible causes include genetic factors, trauma, other chemical carcinogens, and x-ray radiation.
- The edges of each patch are irregular but distinct from the surrounding skin.
- The patch or patches grow very slowly.
- The patches can affect any part of the body, but commonly occur on the lower leg.
- Occasionally, the patches can be sore, irritated or bleed.
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