MULTIPLE BOWEN'S DISEASE OBSERVED IN FORMER WORKERS OF A POISON GAS FACTORY IN JAPAN, WITH SPECIAL REFERENCE TO MUSTARD GAS EXPOSURE

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Abstract
A study was made on five cases of multiple Bowen's disease observed in former workers of a poison gas factory which was in operation from 1929 to 1945 at Okunojima, Hiroshima, Japan. The age of these patients ranged from 63 to 70 years with an average of 66 years. The period engaged in poison gas production averaged 9.3 years. The averaged interval from initiation of the poison gas production to determination of diagnosis of Bowen's disease was 39.2 years. All five patients were engaged in the production of mustard gas which is a vesicant poison gas and an alkylic agent. The number of lesions of Bowen's disease in a patient ranged from 2 to 7. Ten lesions were found on the trunk and 13 on the extremities. In addition, there were numerous pigmented and depigmented spots and hyperkeratotic papular eruptions on the skin of all patients.There are no reports in the literature on Bowen's disease caused by mustard gas. The results of this study strongly suggest that multiple Bowen's disease in workers formerly engaged in the production of poison gas is caused by exposure of mustard gas experimentally demonstrated to be a carcinogen.