What is the Difference Between Actinic Keratosis and Bowen’s Disease

The key difference between actinic keratosis and Bowen’s disease is that actinic keratosis is a skin condition that causes smaller red, pink, skin-coloured, or gray scaly, raised spots on the skin, while Bowen’s disease is a skin condition that causes larger, red, rough, scaly spots on the skin.

Actinic keratosis and Bowen’s disease are two skin conditions that cause red scaly spots on the skin. Both these conditions are precancerous conditions. Both these conditions are usually caused by exposure to sunlight.

CONTENTS

1. Overview and Key Difference
2. What is Actinic Keratosis  
3. What is Bowen’s Disease
4. Similarities – Actinic Keratosis and Bowen’s Disease
5. Actinic Keratosis vs Bowen’s Disease in Tabular Form
6. Summary – Actinic Keratosis vs Bowen’s Disease

What is Actinic Keratosis?

Actinic keratosis or solar keratoses is a condition that causes smaller red, pink, skin-coloured, or gray dry, scaly patches on the skin. Actinic keratosis is caused due to damage by the sun. These patches are not normally serious. But there is a probability of these patches turning into skin cancer. Therefore, it is important to avoid further damage by sunlight.

The symptoms of this condition may include rough, dry, scaly patches on the skin that are usually less than 1 inch in diameter, flat to raised bumps, a hard or wart-like surface, red, pink, or brown color variation, itching or burning sensations, bleeding or crusting, and formation of new patches on the sun-exposed areas of the body like head, neck, hands, and forearms. The risk factors for actinic keratosis include having red or blond hair or blue or light-colored eyes, having a history of sun exposure, tending to form freckles when exposed to sunlight, being older than 40, living in sunny places, working outdoors, and weakened immune system.

Actinic keratosis can be diagnosed through physical examination and skin biopsy. Furthermore, actinic keratosis is treated through a medicated cream or gel such as fluorouracil, imiquimod, or diclofenac, surgical and other procedures such as freezing (cryotherapy), scraping, laser therapy, and photodynamic therapy.

What is Bowen’s Disease?

Bowen’s disease is a skin condition that causes red, scaly patches on the skin. It is a very early form of skin cancer that is easily treatable. This condition usually affects the squamous cells in the out layer of skin. Therefore, it is often called squamous cell carcinoma in situ. The symptoms of Bowen’s disease may include slow-growing, persistent reddish-brown patches or plaques,  dry, scaly skin, flat or slightly raised lesions, and lesions that can itch, ooze pus, bleed or become crusted or tender. Bowen’s disease is caused by chronic ultraviolet (UV) radiation exposure. Moreover, the risk factors for developing Bowen’s disease include long-term exposure to the sun, especially in people with fair skin, having a weak immune system, having previously undergone radiotherapy, and having had human papillomavirus (HPV)  infection.

Diagnosis of Bowen’s disease is made through medical history, investigating skin patches, and skin biopsy in the laboratory. Furthermore, Bowen’s disease is treated through cryotherapy, imiquimod cream or chemotherapy cream (such as 5-fluorouracil), curettage and cautery, photodynamic therapy (PDT), and surgery.

What are the Similarities Between Actinic Keratosis and Bowen’s Disease?

• Actinic keratosis and Bowen’s disease are two skin conditions that cause red scaly spots on the skin.
• Both these conditions are precancerous conditions
• They are caused by chronic exposure to UV light of the sun.
• Both these conditions can be diagnosed through physical evaluation and skin biopsy.
• They are usually treated through specific medications and surgeries.

What is the Difference Between Actinic Keratosis and Bowen’s Disease?

Actinic keratosis is a skin condition that causes smaller red, pink, skin-coloured, or gray scaly, raised spots on the skin, while Bowen’s disease is a skin condition that causes larger red rough, scaly spots on the skin. Thus, this is the key difference between actinic keratosis and Bowen’s disease. Furthermore, the risk factors for actinic keratosis include having red or blond hair or blue or light-colored eyes, having a history of sun exposure, tending to form freckles when exposed to sunlight, being older than 40, living in sunny places, working outdoors, and weakened immune system. On the other hand, the risk factors for developing Bowen’s disease include long-term exposure to the sun, especially in people with fair skin, having a weak immune system, having previously undergone radiotherapy, and having had human papillomavirus (HPV)  infection.

The below infographic presents the differences between actinic keratosis and Bowen’s disease in tabular form for side-by-side comparison.

Summary – Actinic Keratosis vs Bowen’s Disease

UV light exposure can cause a spectrum of changes to the normal skin and lead to skin conditions. Skin conditions due to UV light exposure may include precancerous skin conditions like actinic keratosis, Bowen’s disease, and cancerous skin conditions such as squamous cell carcinoma, basal cell carcinoma, melanoma, and Merkel cell carcinoma. Therefore, actinic keratosis and Bowen’s disease are two skin conditions due to UV light exposure. Actinic keratosis causes smaller red, pink, skin-coloured, or gray dry, scaly patches on the skin, while Bowen’s disease causes larger red, dry, scaly patches on the skin. So, this summarizes the difference between actinic keratosis and Bowen’s disease.

Reference:

1. “Actinic Keratosis.” Mayo Clinic.
2. “Bowen’s Disease.” NHS Choices.

Image Courtesy:

1. “Actinic keratosis on balding head” By Future FamDoc – Own work (CC BY-SA 4.0) via Commons Wikimedia
2. “Bowen11” By Klaus D. Peter, Wiehl, Germany – Self-photographed (CC BY 3.0 de) via Commons Wikimedia