Treatment of Bowen's disease with a specially designed radioactive skin patch

Bowen's disease can be treated by various methods, including surgical excis ion, cryosurgery, laser ablation, curettage, Mohs' microsurgery and ionizin g radiation. Radiotherapy has been a useful therapeutic modality in the tre atment of Bowen's disease and other skin cancers in areas which are difficu lt to excise, especially the central areas of the face, including eyelids, nose and lips. To overcome some of the disadvantages of external radiothera py, a specially designed skin patch coated with high-energy beta-emitter ho lmium-166 was made for topical application at our institute. Twenty-nine si tes of Bowen's disease in eight patients, confirmed by skin biopsy, were tr eated with Ho-166 patches. The patches were applied to the surface of skin cancers for 30-60 min for a total radiation dose of 35 Gy (3500 rads), One to two weeks after application of the Ho-166 patch, desquamation, erythema or erosion developed in treated sites, but these acute radiation reactions healed gradually with epithelial regeneration, and they showed good functio nal and cosmetic results without any complications. Follow-up biopsies were performed 1-5 months after Ho-166 patch therapy, and they did not show any signs of Bowen's disease. One to two years after treatment with Ho-166 Ski n patches, there were no recurrences of Bowen's diseases and no late compli cations. The Ho-166 patch is an effective and convenient alternative method for the treatment of Bowen's disease that yields good cosmetic and functio nal results.