A superficial BCC is distinguished by its shiny, pearly, thread-like border, which is absent in the duller, scaly plaque of Bowen's disease.
An eczematous patch is typically itchy and will respond to topical steroids, whereas a Bowen's plaque is persistent, asymptomatic, and unresponsive to such treatment.
Paget's disease is a specific adenocarcinoma presenting as a unilateral plaque on the nipple or anogenital region, a distinct location from Bowen's on sun-exposed skin.
Psoriasis typically presents with multiple, symmetrical, silvery-scaled plaques, whereas Bowen's disease is almost always a single, persistent, reddish-brown, scaly patch.
Bowen's is SCC in situ (confined to the epidermis), and is distinguished from invasive SCC by being a flat patch, whereas invasive SCC is an indurated, thicker nodule or ulcer.
This fungal infection is distinguished by its annular shape with an active border and can be confirmed with a positive KOH test, which would be negative in Bowen's disease.
