A clinicopathologic and histochemical study erythroplasia of queyrat. Erythroplakia of the genital mucosae is often referred to as erythroplasia of queyrat. Erythroplasia of queyrat is a squamouscell carcinoma of the glans penis head of the penis or inner prepuce foreskin in males, and the vulvae in females. This condition was described by queyrat in 1911 as erythroplasie du gland. Development of squamous cell carcinoma from erythroplasia. It usually is not aggressive but can become locally invasive, and it is advisable for a man who might have this condition to receive prompt treatment. This gave rise to the term erythoplasia of queyrat. Two cases of erythroplasia of queyrat with persistent post. The lesions cleared completely, and recurrencefree followup periods ranged from 20 to 60 months. Limerick, ireland abstract a 58yearold caucasian male presented to the urology clinic reporting an approximate oneyear history of a persistent irritating, slowly progressive, glans penis redness.
Pein associated with invasive carcinoma is more prevalent in regions with a high incidence of penile cancer. A digital manual for the early diagnosis of oral neoplasia. Bowens disease of the glans penis erythroplasia of. Development of squamous cell carcinoma from erythroplasia of queyrat following photodynamic therapy. The changes are those of a carcinoma in situ, as in bowens disease. The course of involution of the lesion and the pretreatment and posttreatment biopsy specimens are pictorially presented. There were normal histological findings in posttreatment biopsy specimens in two of the. Its appearance can sometimes resemble erythroplasia of queyrat in situ scc of the glans. Nov 30, 2009 erythroplasia of queyrat is a carcinoma in situ that mainly occurs on the glans penis.
Observations from 100 men with erythroplasia of queyrat eq indicate that the disease is a. Bowens disease and erythroplasia of queyrat clinical gate. There are several noninvasive treatment options for erythroplasia of queyrat such as photodynamic therapy, cryosurgery and applying various kinds of topical agents. Erythroplasia of queyrat eq is a carcinoma in situ of the mucosal surface of the penis. Erythroplasia of queyrat uf health, university of florida. Erythroplasia of queyrat is a carcinoma in situ of the mucosa and the transitional epithelia. A case of erythroplasia of queyrat treated with imiquimod. Erythroplasia of queyrat definition of erythroplasia of. Erythroplasia of queyrat is a clinical term applied to hsil squamous cell carcinoma scc in situ of the glans penis. Its histology and behaviour are identical to bowens disease of skin. Erythroplasia of queyrat in a 72yearold patient was successfully treated with 5% fluorouracil cream topically in four weeks without any discomfort.
Department of cellular pathology, southmead hospital, bristol, uk. The histology was grade 1 g1 in 36, grade 2 g2 in 18, grade 3 g3 in 28, and unknown in 19 patients. Erythroplasia of queyrat is squamous cell cancer in situ of the glans penis and i encounter it occasionally in my the woodlands dermatology and conroe dermatology clinics. Circumcision at an early age is thought to prevent its development. Erythroplasia of queyrat is a rare in situ carcinoma of the uncircumcised man and its treatment depends on the extent and location of the lesion. Its appearance can sometimes resemble erythroplasia of queyrat. Erythroplasia of queyrat is caused by high risk hpv types 16,18,31,35. Carcinomainsitu of the penis and surrounding genital region is also called erythroplasia of queyrat or bowens disease. Is distinction between erythroplasia of queyrat and. Erythroplasia of queyrat jama dermatology jama network.
Lesions involving the shaft of the penis are referred to as bowens disease while those affecting the glans and prepuce are called erythroplasia. Bowenoid papulosis, bowen disease and erythroplasia of queyrat. Backgroundobjectives the clinical diagnosis of penile intraepithelial neoplasia is challenging. This terminology often causes confusion the histopathology and clini of these lesions. A case of erythroplasia of queyrat treated with imiquimod 5%. Erythroplasia of queyrat is a type of skin cancer of the penis, seen most commonly in men who are not circumcised. Erythroplasia of queyrat is a particular type of bowens disease that can arise on the glans or prepuce in males. Since the recognition of the role of hpv, undifferentiated pein can be further subdivided into basaloid andor warty subtypes. Also, mohs micrographic surgery has been used in the treatment of erythroplasia of queyrat. Histopathological examination hematoxylineosin stain shows identical. The clinical appearance is that of a sharply demarcated, erythematous plaque that is persistent and slowly enlarging. The glans is the predominant location of this lesion, and its nonspecific presentation a sharply defined red patch or plaque, may often lead to a misdiagnosis as one of many mucosal dermatoses.
Glans mucosa is extensively involved by erythematous lesion resembling erythroplasia of queyrat microscopic histologic description epidermal atrophy, bandlike infiltrate of plasma cells in dermis, hemosiderin pigment laden macrophages siderophages, edema and numerous capillaries. Another french author, queyrat, 4 in 1911 devoted himself to a more exhaustive study of the condition and gave it the name of erythroplasie. Histopathology peniserythroplasia of queyrat youtube. Erythroplasia of queyrat treated with imiquimod 5% cream. Erythroplasia of queyrat bowen disease of the glans penis. The following diagnostic procedures may be useful in excluding other infectious processes. Erythroplasia of queyrat is a term used to describe a rare premalignant lesion of penile in situ squamous cell carcinoma. Discussion erythroplasia of queyrat occurs on advanced age range from 50 to 60 years of old and evolves in epidermoid carcinoma in 33%of cases 1. The soft palate, the floor of mouth, the ventral surface of tongue and the retromolar area are the most common sites of. A 58yearold caucasian male presented to the urology clinic reporting an approximate oneyear history of a persistent irritating, slowly progressive, glans penis redness. Erythroplasia of queyrat is a carcinoma in situ that mainly occurs on the glans penis, the prepuce, or the urethral meatus of elderly males. The condition is most often seen in men who have not been circumcised. Instead of the keratin, there is a papillae connective tissue with enlarged capillaries.
This term is used only when the cancer occurs on the penis. Poor hygiene and local irritation, as well as coinfection with hpv8 and hpv16. Erythroplasia of queyrat eq is an in situ squamous cell carcinoma of the penis. Erythroplasia of queyrat treated with 5% imiquimod cream. Erythroplasia of queyrat is a carcinoma in situ that mainly occurs on the glans penis. Erythroplasia of queyrat treated with topical 5fluorouracil scielo. The cancer is called squamous cell carcinoma in situ.
It is soft on palpation and does not become indurated until an invasive carcinoma develops in it. Basal cell carcinoma of the penis is usually located along the penile shaft. Histological aspect of the erythroplasia of queyrat at 40 growths. Bowens disease and erythroplasia of queyrat plastic. In 1911, queyrat described a sharply defined, bright red, glistening velvety precancerous lesion of the glans penis, which he termed erythroplasia 11 although red lesions of the oral mucosa have been noted for many years, the use of the term erythroplakia in this context has been common for only about 25 years. Pathology outlines squamous cell carcinoma in situ bowen. It appears as a red macule or plaque with welldemarcated borders.
Clinically, these lesions present as erythematous plaques. Erythema and ulceration may predominate in some cases. Additionally, biopsy should be performed on therapyresistant lesions. Microscopically it is identical to other types of hsil. Treatment of carcinoma in situ of the glans penis with. Erythroplasia of queyrat histopathology of penis video. Dermatoscopic findings of penile intraepithelial neoplasia. We report a case of a persistent penile plaque on the glans penis of allegedly more than 20 years duration, which was refractory to circumcision and local treatment. Erythroplakia is seldom multicentric and rarely covers extensive areas of the mouth. Clinically, pin is comprised of a clinical spectrum including 3 different entities. Erythroplasia of queyrat an overview sciencedirect topics.
The precancerous nature of the lesions has become the most widely used histopathologic diagnosis erythroplakia 2. Case report a 58yearold caucasian male presented to the urology clinic reporting an approximate oneyear history of a persistent irritating, slowly progressive, glans penis redness. It resembles bowens disease and therefore the terms are frequently equated. At a later date 1911, queyrat 2 described in detail several cases of what was apparently an identical condition. Specifically, biopsy should be performed on any areas with signs of bleeding, ulceration, or papillomatous change. Erythroplakia is defined as a fiery red patch that cannot be characterized either clinically or pathologically as any other definable lesion. Pathology outlines penile intraepithelial neoplasia pein. Pdf combined organsparing treatment for penile cancer. A case of erythroplasia of queyrat treated with imiquimod 5% cream and excision jee woong choi, m. Initially, 5fluorouracil5% was applied to the entire lesion twice daily for two weeks.
Erythroplakia refers to an oral condition that appears as red lesions on the mucus membrane but cannot be attributed to any other illness or condition 1. Pdf chronic erythematous lesions of the penis may result from a variety of. Erythroplasia of queyrat eq is an uncommon carcinoma in situ that usually arises on the mucosa of the glans penis or prepuce as red, shiny, sharply demarcated velvety plaques. Mar 23, 2020 erythroplasia of queyrat is a type of skin cancer of the penis, seen most commonly in men who are not circumcised. Positive results were obtained after 4 weeks of topical application of 5% imiquimod cream, once daily, 5. Three patients with biopsyconfirmed erythroplasia of queyrat were treated with topically applied fluorouracil. See also candidal balanitis, zoons balanitis balanitis xerotica obliterans, 110. Erythroplakia pictures signs, symptoms and treatment. Erythroplasia queyrat, naked papillary epithelioma. Erythroplasia of queyrat eq is a rare in situ squamous cell carcinoma scc of the. Tarnovsky originally described erythroplasia of queyrat in 1891, but it was queyrat who coined the term erythroplasia in 1911. A premalignant condition morphologically characterised by the presence of the characteristic pagets cells in the intraepithelial tissue of the penis.
Nodepositive disease was commoner in patients with g3. Whitish areas in glans, coronal sulcus or inner foreskin. Erythroplasia of queyrat treated with topical 5fluorouracil 43 given this diagnosis and the patients age, we chose to perform a nonsurgical treatment with topical 5fluorouracil5%. We report a case of erythroplasia of queyrat eq with zoons balanitis and discuss the classification of the lesion through the analysis of overlapping histological. The underlying risk factors are represented by, among others, uncircumcision, hpv infection and a lack of local hygiene. These may appear as smooth, velvety, granular or nodular lesions often with a welldefined margins adjacent to normal looking mucosa. Bowens disease and erythroplasia of queyrat eq are defined as intraepidermal squamous cell carcinoma, the latter occurring on the penis. In this video you can see erythroplasia of queyrat in histopathological image of penis. Treatment of erythroplasia of queyrat with liquid nitrogen cryosurgery. Squamous cell carcinoma in situ on the penile mucosa or transitional surfaces is also known as erythroplasia of queyrat.
Dermis erythroplasia queyrat information on the diagnosis. Treatment of erythroplasia of queyrat often involves removal or destruction of the lesion. A clinical diagnosis of erythroplasia of queyrat was established and the test for hpv revealed an association with subtype 16 which excluded other benign inflammatory conditions. The diagnosis of erythroplasia of queyrat eq is made via histological examination. Article information, pdf download for erythroplasia of queyrat with. Penile intraepithelial neoplasia is a rare precancerous disease of the outer skin layer epidermis of the penis. Undifferentiated pein encompasses the clinically defined entities of bowens disease and erythroplasia of queyrat, as well as previously defined squamous cis. The topic erythroplasia of queyrat you are seeking is a synonym, or alternative name, or is closely related to the medical condition squamous cell carcinoma in situ of penis. Rubin named incipient carcinoma with the aim of describing the erythroplakia microscopic properties he observed in the same era. Progression to invasive carcinoma may occur, and spontaneous regression is unlikely. In the region, one third of penile squamous cell carcinoma in situ cases progress to invasive squamous cell carcinoma.
Erythroplasia of queyrat histopathology of penis video a a a. Nov 07, 2019 erythroplasia of queyrat eq is an in situ squamous cell carcinoma of the penis. Zoons balanitis, penile intraepithelial neoplasiacarcinoma in situ erythroplasia of queyrat eq, squamous cell cancer of the penis, malignant melanoma of the penis and rarely basal cell cancer of the penis. Absence of pcrdetectable human papilloma virus in erythroplasia of queyrat using a comparative control group. The use of topical agents in the treatment of carcinoma in situ cis of the penis has been well described in the literature.
It mainly occurs in uncircumcised males, over the age of 40. Erythroplakia is a clinical term to describe any erythematous red area on a mucous membrane, that cannot be attributed to any other pathology 805 the term erythroplasia was coined by louis queyrat to describe a precancerous red lesion of the penis. Erythroplasia definition of erythroplasia by medical dictionary. Previous studies have been limited by small sample size and imprecise end points. Erythroplasia of queyrat is a clinical expression of carcinoma in situ of the penis. May 14, 2007 histopathology penis erythroplasia of queyrat. As the condition is strongly associated with uncircumcised males, a high moisture. Oral erythroplakia has the highest risk of malignant. Aug 07, 2016 31 bowens disease and erythroplasia of queyrat thomas d. Erythroplasia of queyrat is an early form of skin cancer found on the penis. The condition is typically found in men who have not had the foreskin of the penis surgically removed circumcision.
Penile squamous intraepithelial lesion sil low and high grade has been used to establish similarities with cervical sil but penile precancerous lesions are actually more similar to vulvar lesions than to cervical lesions. Methods employed include cryotherapy, laser ablation, and surgical excision. Darier accepted this new name, and the disease is now generally known as the erythroplasie, erythroplasia, erythroplakie or erythroplakia of queyrat. Department of dermatology, seoul national university college of medicine, seoul, korea imiquimod is a new immunomodulating agent with antitumor and antiviral properties that has been shown to be clin. The term erythroplasia of queyrat, rather than simply scc in situ or bd, is preferred for this condition because it is clinically distinct. Histopathology of the lesion is essential in making a diagnosis. Other names for penile intraepithelial neoplasia include. A clinicopathologic and histochemical study graham, james h helwig, elson b. We report a case of erythroplasia of queyrat eq with zoons balanitis and. Although there have been case reports of the simultaneous involvement of pcb with in situ and invasive scc, pcb is a benign entity.
The most common areas in the mouth where erythroplakia is found are the floor of the mouth, buccal vestibule, the tongue, and the soft palate. A case is reported in which the diagnosis was established by biopsy and which was treated by excision and repair with a free skin graft. Erythroplasia of queyrat eq is a carcinoma in situ that appears as a well. Usually on skin not exposed to sunlight, such as trunk called erythroplasia of queyrat if at glans penis, vulva, oral cavity actinic keratosis with only a single layer of atypical keratinocytes may be invasive but bowen disease seldom is.
Pdf absence of pcrdetectable human papilloma virus in. Over the years, the patient repeatedly presented with a circumscribed inflammatory lesion of the glans penis, diagnosed as zoons balanitis on the basis of clinical aspects and two biopsies. A relatively rare precancerous lesion was described as early as 1893 by fournier and darier. Erythroplasia of queyrat is a premalignant disease. Erythroplasia of queyrat deirdre mary fanning, hugh flood department of urology, midwestern regional hospital, dooradoyle, limerick, co. Penile intraepithelial neoplasia pin, or penile squamous cell carcinoma in situ, is a rare disease with high morbidity and mortality rates. Squamous cell cancer in situ can occur on any part of the body. May 29, 2012 differential diagnosis included balanitis example. The reddish color of the patches has been attributed to lack of a keratin layer on the mucosal tissue. Erythroplasia of queyrat eq is an in situ scc affecting the mucosal surfaces of the penis in uncircumcised males. An overview of benign and premalignant lesions of the foreskin. Given the size and location of the lesion, preventing the surgical option, we performed the treatment with co2 laser. We describe the case of a 68 years old patient, with clinical and histological diagnosis of erythroplasia of queyrat. Histological progression of the disease over a period of five years was demonstrated.
Erythroplasia of queyrat of the glans penis on a background of zoons plasma cell balanitis. Squamous cell carcinoma in situ of penis is a malignant condition affecting the skin or mucosal membranes of the penis. It is often asymptomatic, although some patients may complain of a sore, burning or metallic sensation. A biopsy with subsequent histopathological examination is. Erythroplasia of queyrat usually occurs in uncircumcised men. No specific dermoscopic criteria for penile intraepithelial neoplasia have been described in the lite. Selected cases of eq have been treated successfully using 5fluorouracil. We obtained a favorable result fifteendays after the. European guideline for the management of balanoposthitis.
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