Bowen's disease is an intraepidermal
squamous cell carcinoma usually consisting of a solitary lesion. However, multiple Bowen's lesions are one of the characteristics of arsenicalism in endemic areas where people drink deep well water containing high concentrations of
arsenic along the southwest coast of Taiwan. This work seeks to clarify the differences between multiple
Bowen's disease in the blackfoot disease endemic area, and solitary
Bowen's disease in a non-endemic area by means of Ks 8.12 monoclonal
cytokeratin antibody staining. Ks 8.12 may be regarded as a specific antibody for
Keratin 16 in the skin and is used as a marker for hyperproliferation. Our results show that Ks 8.12 staining of normal skin in patients with a solitary Bowen's lesion is patchy and always restricted to the basal cell layer. By contrast, the normal skin of patients with multiple Bowen's lesions shows diffuse Ks 8.12 staining of the basal cell layer and various degrees of staining of the suprabasal layers. Similar results were observed in both solitary and multiple Bowen's lesions showing diffuse Ks 8.12 staining of the epidermis. Our results revealed clear differences in
keratin expression between the clinically normal skin of patients with solitary
Bowen's disease and that of patients with chronic arsenicalism. Finally the clinically normal skin of patients with multipole
Bowen's disease showed characteristic changes in the expression of
Keratin 16 in the suprabasal layers.