Penile intraepithelial neoplasia: clinical spectrum and treatment of 35 cases

• Published in: British journal of dermatology (1951) Vol. 147; no. 6; pp. 1159 - 1165
• Main Authors: Porter, W.M., Francis, N., Hawkins, D., Dinneen, M., Bunker, C.B.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.12.2002; Blackwell; Oxford University Press
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bowen's Disease - pathology; Bowen's Disease - therapy; Bowen's Disease - virology; bowenoid papulosis; Carcinoma in Situ - pathology; Carcinoma in Situ - therapy; Carcinoma in Situ - virology; Circumcision, Male; Erythroplasia - pathology; Erythroplasia - therapy; Erythroplasia - virology; Gynecology. Andrology. Obstetrics; Humans; Immunomodulators; Male; Male genital diseases; Medical sciences; Middle Aged; Papillomaviridae; Papillomavirus Infections - complications; penile intraepithelial neoplasia; Penile Neoplasms - pathology; Penile Neoplasms - therapy; Penile Neoplasms - virology; Pharmacology. Drug treatments; Risk Factors; Treatment Outcome; Tumor Virus Infections - complications; Tumors; Human; Antineoplastic agent; Skin disease; Premalignant lesion; Carcinoma in situ; Imiquimod; Male; Malignant tumor; Bowen disease; Genital diseases; Case study; Immunomodulator; Pathology; Symptomatology; Penile diseases; Chemotherapy; Bowenoid papulosis; Erythroplasia of Queyrat; Treatment; penile intraepithelial neoplasia; Penis; Adult; Intraepithelial neoplasia; Male genital diseases
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1046/j.1365-2133.2002.05019.x

Summary Background  Penile intraepithelial neoplasia (PIN) is the term used to describe erythroplasia of Queyrat (EQ), Bowen's disease (BD) and bowenoid papulosis (BP). These conditions are distinct clinical entities and have different epidemiological and aetiological associations and prognostic implications. Objectives  To describe the presentation and treatment of patients with PIN. Methods  Thirty‐five patients presenting with PIN over a 7‐year period are described. Results  Our observations include: (i) patients with BP are younger than those with EQ or BD and sometimes have a history of immunosuppression; (ii) patients with BP usually have a history or clinical evidence of previous genital human papillomavirus infection; (iii) patients with EQ often have a concurrent penile dermatosis (lichen sclerosus or lichen planus); (iv) patients with PIN are usually uncircumcised; and (v) response to treatment of BP depends on the integrity of the immune system. Conclusions  We recommend vigorous treatment of all patients with PIN, including circumcision. Smoking should be actively discouraged. Patients should have life‐long follow‐up and partners of patients with BP should be screened for other forms of intraepithelial neoplasia (cervical and anal).