How effective is photodynamic therapy for Bowen's disease?

Bowen's disease is an early form of squamous cell carcinoma confined to the outer skin layer. It often appears as a persistent scaly or crusted patch. Photodynamic therapy uses a light-sensitive preparation followed by a planned light exposure to target abnormal cells in the treated area.

The clinician must check that the lesion is appropriate for this approach. A thick, invasive-looking, recurrent, or difficult-to-define patch may need a biopsy or a treatment that removes tissue. Healing redness and crusting can temporarily make the area look worse, so effectiveness is assessed after recovery rather than on the same day.

Before treatment, confirm the diagnosis and ask how the borders will be marked. Discuss expected discomfort, light avoidance, wound care, and whether a second treatment or another method might be needed if abnormal skin remains.

Keep the area protected as directed, avoid scratching or peeling the crust, and attend the review visit. Report any persistent roughness or a new patch nearby; treatment addresses the selected area and does not stop future sun-related damage.

Contact the treating team for increasing pain, spreading redness, marked swelling, pus, or fever. Arrange prompt review if the patch continues to thicken, bleeds, becomes tender, or does not heal after the expected recovery period.

Has the lesion been confirmed as Bowen's disease, and does its depth make photodynamic therapy suitable? How will you check the response? What should I do about crusting or sensitivity, and which changes after healing should prompt an earlier appointment?