Combined carbon dioxide and pulsed dye laser treatment for Bowen’s disease in a patient with high Fitzpatrick skin type: A case report

A 78-year-old male with a Fitzpatrick skin phototype V presented with a 3-year history of a non-healing, solitary, scaly plaque on his lower leg. The lesion was clinically and histologically diagnosed as Bowen’s disease (squamous cell carcinoma in situ ). This detailed case report outlines the management of the lesion using a combination of ablative carbon dioxide (CO2) laser and vascular pulsed dye laser (PDL) therapy. The treatment was performed in a single, well-tolerated session, where a single pass with the CO2 laser was immediately followed by a treatment with the PDL. This novel synergistic approach was designed to simultaneously target the bulk of the epidermal tumor through ablation and the critical underlying vascular network. This approach was chosen to target both the epidermal tumor cells and the underlying vascular supply, offering a comprehensive treatment strategy.