Successful treatment of scalp Bowen's disease with 5-Aminolevulinic acid-photodynamic therapy combined with electric microneedling: A case report

• First report of scalp Bowen’s disease successfully treated with nanoneedle-assisted PDT. • Combined electric microneedling enhanced drug delivery and photodynamic efficacy. • Complete clinical clearance achieved after five sessions with no recurrence at 18 months. • Offers a novel non-surgical option for complex, inoperable cases of Bowen’s disease. This case report presents a 79-year-old male with scalp Bowen's disease and multiple comorbidities, precluding surgery. An innovative combination of nano-microneedle pretreatment and 5-Aminolevulinic Acid-Photodynamic Therapy (5-ALA-PDT) was utilized. Following five sessions, complete clinical clearance was achieved, maintained over 18 months of follow-up without recurrence. This synergistic approach enhances drug delivery and light efficacy, overcoming traditional PDT penetration limits. To our knowledge, this is the first reported case of successful non-surgical treatment for scalp BD using microneedle-assisted PDT, offering a novel therapeutic option for complex, inoperable cases.