Advertisement

Erythroplasia of Queyrat

  • Konstantinos KrasagakisEmail author

Abstract

Erythroplasia of Queyrat (EQ) is a carcinoma in situ of the mucosal surface of the penis. Poor hygiene and local irritation, as well as coinfection with HPV-8 and HPV-16, are potential risk factors. It presents as a well-demarcated, velvety red plaque of variable size, with smooth surface, involving the glans penis or the inner surface of the prepucial skin and may progress to invasive squamous cell carcinoma in 10–33 % of the cases. Treatment of choice for EQ is surgical excision of the lesion, but the preservation of the functionality of the penis and of the sexual activity may pose limitations to the extent and radicality of surgery. Safety margins of 5 mm are generally acceptable for excision, which on most occasions result in large defects. Therefore, Mohs micrographic surgery is suggested as an effort to spare unaffected tissue. Carbon dioxide or neodymium:YAG laser therapy and the application of 5-fluorouracil cream or imiquimod cream are the main alternatives to surgery in order to preserve function and to not affect sexual activity.

Keywords

Erythroplasia of Queyrat Carcinoma in situ Penis Surgery Laser Drug therapy 

References

  1. Ahmed I, Berth-Jones J, Charles-Holmes S, O’Callaghan CJ, Ilchyshyn A. Comparison of cryotherapy with curettage in the treatment of Bowen’s disease: a prospective study. Br J Dermatol. 2000;143(4):759–66.PubMedGoogle Scholar
  2. Alnajjar HM, Lam W, Bolgeri M, Rees RW, Perry MJ, Watkin NA. Treatment of carcinoma in situ of the glans penis with topical chemotherapy agents. Eur Urol. 2012;62(5):923–8.PubMedGoogle Scholar
  3. Angerer-Shpilenya M, Gaisa NT, Jakse G. Excision of carcinoma in situ of the glans penis with reconstructive plastic surgery. Urologe A. 2010;49(3):392–5.PubMedGoogle Scholar
  4. Axcrona K, Brennhovd B, Alfsen GC, Giercksky KE, Warloe T. Photodynamic therapy with methyl aminolevulinate for atypial carcinoma in situ of the penis. Scand J Urol Nephrol. 2007;41(6):507–10.PubMedGoogle Scholar
  5. Bunker CB, Neill SM. The genital, perianal and umbilical regions. In: Burns T, Breathnach SM, Cox N, Griffiths C, editors. Rook’s textbook of dermatology, vol. 4. 8th ed. Oxford: Blackwell Science; 2010. p. 71.38–9.Google Scholar
  6. Conejo-Mir JS, Muñoz MA, Linares M, Rodríguez L, Serrano A. Carbon dioxide laser treatment of erythroplasia of Queyrat: a revisited treatment to this condition. J Eur Acad Dermatol Venereol. 2005;19(5):643–4.PubMedGoogle Scholar
  7. Crispen PL, Mydlo JH. Penile intraepithelial neoplasia and other premalignant lesions of the penis. Urol Clin North Am. 2010;37(3):335–42.PubMedGoogle Scholar
  8. Frimberger D, Hungerhuber E, Zaak D, Waidelich R, Hofstetter A, Schneede P. Penile carcinoma. Is Nd: YAG laser therapy radical enough? J Urol. 2002;168(6):2418–21.PubMedGoogle Scholar
  9. Goette DK, Carson TE. Erythroplasia of Queyrat: treatment with topical 5-fluorouracil. Cancer. 1976;38(4):1498–502.PubMedGoogle Scholar
  10. Graham JH, Helwig EB. Erythroplasia of Queyrat. A clinicopathologic and histochemical study. Cancer. 1973;32(6):1396–414.PubMedGoogle Scholar
  11. Hadway P, Corbishley CM, Watkin NA. Total glans resurfacing for premalignant lesions of the penis: initial outcome data. BJU Int. 2006;98(3):532–6.PubMedGoogle Scholar
  12. Kim B, Garcia F, Touma N, Moussa M, Izawa JI. A rare case of penile cancer in situ metastasizing to lymph nodes. Can Urol Assoc J. 2007;1(4):404–7.PubMedPubMedCentralGoogle Scholar
  13. Lee MR, Ryman W. Erythroplasia of Queyrat treated with topical methyl aminolevulinate photodynamic therapy. Australas J Dermatol. 2005;46(3):196–8.PubMedGoogle Scholar
  14. Malek RS. Laser treatment of premalignant and malignant squamous cell lesions of the penis. Lasers Surg Med. 1992;12(3):246–53.PubMedGoogle Scholar
  15. Malloy TR, Wein AJ, Carpiniello VL. Carcinoma of penis treated with neodymium YAG laser. Urology. 1988;31(1):26–9.PubMedGoogle Scholar
  16. McLean M, Akl AM, Warde P, Bissett R, Panzarella T, Gospodarowicz M. The results of primary radiation therapy in the management of squamous cell carcinoma of the penis. Int J Radiat Oncol Biol Phys. 1993;25(4):623–8.PubMedGoogle Scholar
  17. Meijer RP, Boon TA, van Venrooij GE, Wijburg CJ. Long-term follow-up after laser therapy for penile carcinoma. Urology. 2007;69(4):759–62.PubMedGoogle Scholar
  18. Paoli J, Ternesten Bratel A, Löwhagen GB, Stenquist B, Forslund O, Wennberg AM. Penile intraepithelial neoplasia: results of photodynamic therapy. Acta Derm Venereol. 2006;86(5):418–21.PubMedGoogle Scholar
  19. Schlenker B, Tilki D, Seitz M, Bader MJ, Reich O, Schneede P, Hungerhuber E, Stief CG, Gratzke C. Organ-preserving neodymium-yttrium-aluminium-garnet laser therapy for penile carcinoma: a long-term follow-up. BJU Int. 2010;106(6):786–90.PubMedGoogle Scholar
  20. Sonnex TS, Ralfs IG, Plaza de Lanza M, Dawber RP. Treatment of erythroplasia of Queyrat with liquid nitrogen cryosurgery. Br J Dermatol. 1982;106(5):581–4.PubMedGoogle Scholar
  21. Stables GI, Stringer MR, Robinson DJ, Ash DV. Erythroplasia of Queyrat treated by topical aminolaevulinic acid photodynamic therapy. Br J Dermatol. 1999;140(3):514–7.PubMedGoogle Scholar
  22. Tietjen DN, Malek RS. Laser therapy of squamous cell dysplasia and carcinoma of the penis. Urology. 1998;52(4):559–65.PubMedGoogle Scholar
  23. Varma S, Holt PJ, Anstey AV. Erythroplasia of queyrat treated by topical aminolaevulinic acid photodynamic therapy: a cautionary tale. Br J Dermatol. 2000;142(4):825–6.PubMedGoogle Scholar
  24. Wieland U, Jurk S, Weissenborn S, Krieg T, Pfister H, Ritzkowsky A. Erythroplasia of queyrat: coinfection with cutaneous carcinogenic human papillomavirus type 8 and genital papillomaviruses in a carcinoma in situ. J Invest Dermatol. 2000;115(3):396–401.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of DermatologyUniversity General Hospital of HeraklionHeraklionGreece

Personalised recommendations