Hi again.  I am quite calm at the moment i suppose but i don't think it has sunk in yet!

I work in a gp surgery, as you may know.  I have had eczema on my left ankle for about 2 - 3 months and it is refusing to clear up even with Hydrocortisone 1%.  Then a couple of weeks ago i got a smaller patch on my other leg and now a little patch a little bit further round from that one.  I have been using moisterizer gallore, no use!
So i asked our dermatology specialist at work this morning, head GP of the practice, his opinion.  He thought it was eczema, nothing to worry about and advised another cream and just to choose a moisterizer i wanted to go along with it.  Because of the symptoms i have with it: itching when warm, weeping when scratched etc, he said that it was fine.  Nothing else crossed my mind to be honest.

I rang my gp and got in for this afternoon, thinking he would diagnose eczema and give me the cream on a prescription.  How wrong i was.  My 10 year old came with me and i was quite calm whilst waiting too.  He looked at it and said that i had Bowen's disease.  I waited for him to ellaborate, which he didn't.  So i asked what that was.  He said oh it's nothing to worry about at all!  So i said ok.  He then said that i think what you have on one leg is different than what you have on the other leg.  Ok, fine.  Still waiting for the cream to fix it......
Then I asked what Bowen's disease was and he said oh it's nothing at all to worry about, you just have skin cancer!!!!
Well, as you can imagine my gob must have just fell open, even my 10 year old was shocked.  I said but i thought skin cancer was something to worry about.  He said no, not at all, that's why i wasn't going to tell you what the names were!  Then he said i am referring you to the hospital to have bit's taken off to be looked at under the microscope!  I thought, ye, that's what you think mate.
I just sat and nodded.
Then he said so it's either eczema, Bowen's disease or skin cancer!  I aasked if i could still keep trying with cream and he said well if it hasn't done any good so far i doubt that it will now but there is no harm in trying and it will help in a diagnosis if it does get better.  I did say to him earlier that i had a gp look at it, that is why i had come to get some cream.  I said who it was and he sat there nodding and smiling and said, oh i trained him!!
I just couldn't believe it.  How much more have i got to take cus i really don't think that i can take much more, i have really had enough to be honest.
My hubby and kids think that it is eczema and i suppose i do really too, it is just the horrible, flipant way that he just blurted it all out as if it was nothing at all.  Even as i was coming out he still said that no matter what it was, even if it was skin cancer, it is nothing at all to worry about!!  Is the man completely mad or something?  I would never speak to one of my patients in that way, never!  I rang the surgery where i work to speak to the gp that i spoke to this morning but he had finished so i will have to wait until Monday for that.  But i did go to the chemist and explain to the pharmacist and he looked as shocked as i felt.  He said you are wound up aren't you and i said that i was and i was angry more than anything.  He recommended the same cream that the gp did this morning, Eumovate, as it is a bit stronger than Hydrocortisone 1%.  Also Aqueous cream as a moisterizer.
We bought them both over the counter and i will try them.  I have looked up pictures on Bowen's disease and i suppose there are similarities to what i have, but not great ones.  Also, like we said and also the pharmacist, if you have skin cancer then it isn't just suddenly going to appear on different parts of the leg.  It would be a patch that would grow wouldn't it?  I don't know, just hoping that the cream will work and i will go and shove my leg under his nose and laugh!xx

Initially, I'm a bit perplexed by the onset and presentation of all of this. You stated that you noticed patches of eczema on one limb and then the next, treating them unsuccessfully with over-the-counter creams and moisturizers. Then you're told by a physician at some point that the eczema is interlaced with dermatological signs of Bowen's disease.

First of all, how big are the patches being referred to as Bowen's disease and how long have they been present? Have you ever had eczema before this occasion? Because of the season, I also want to ask whether you've been able to endure chronic exposure to the sun in the form of tanning, etc?

Frankly, none of this is making sense to me as a physician unless the chronology of events differs from what is depicted in your posting. It would be extremely uncommon for a patient to experience the onset of eczema on their extremities while simultaneously developing Bowen's disease. In fact, I don't think I've ever even heard of such a thing occurring and I've been trodding the halls of a hospital for more than 40 years now.

Because I am unable to make direct observation, I'm unable to tell exactly what you have, but I'm the one who will be shocked if you've suddenly developed some type of co-morbid process such as that described. I'll share some things with you nevertheless.

Bowen's disease is a rather common presentation in dermatology and is associated with squamous-cell carcinoma of the epithelial tissues, meaning that it exists on the surface of the skin. It is not the sort of thing to lose your head over at all. Never expect the medical community to deliver such news with calamity as well. It is not a serious condition and just because it has the "c" word, does not mean that they should take you into a private setting and deliver the news with heightened overtones. It's just not the case here at all.

Even in the far-reaching event that it turns out to be Bowen's, we regard squamous and basal cell carcinoma these days with a curative perspective. That means that if someone gets basal or squamous, we can cure it. Easy as that.

Again I'm a bit perplexed, even somewhat skeptical, that both eczema and Bowen's disease has suddenly manifested itself on your lower extremities within the past 12 weeks or so. If warranted, they will likely biopsy a portion from both areas using a punch, which is performed under local anesthesia and quite painless. My opinion is that it's either one or the other (Bowen's or eczema), but not both. If Bowen's carcinoma is confirmed, then you simply need to have further tests done to search out the underlying cause unless already known. It is, again, treatable to the point of cure.

I'd be interested to know the results if you care to post them.

Best regards and Good Health