Abstract
Erythroplasia of Queyrat (EOQ) is a squamous cell carcinoma in situ most commonly located on the glans penis or prepuce. EOQ accounts for roughly 10 % of all penile malignancies and may lead to invasive squamous cell carcinoma. Standard therapy includes local excision, partial or total penectomy, cryotherapy, and topical cytotoxic agents. Treatment of EOQ has proven to be challenging due to low response rates and recurrence. In addition, radical procedures can significantly affect sexual function and quality of life. Alternative laser treatments and photodynamic therapy (PDT) offer promising results for treating EOQ. A systemic review of the literature was performed for articles discussing laser and light therapy for EOQ. Among the patients treated with the CO2 laser, 81.4 % of cases had complete remission after one session of treatment. Patients treated with PDT presented with more variable results, where 62.5 % of those treated with methyl aminolevulinate photodynamic therapy (MAL-PDT) achieved complete remission. Aminolevulinic acid (ALA-PDT) treatment showed a similar rate of remission at 58.3 %. One study utilized the Nd:YAG laser, which resulted in a recurrence of the lesion in four of the five patients treated. Of the methods reviewed, the CO2 laser offered the most promising results with a cosmetically excellent prognosis. Further studies with larger power and longer follow-up times are needed to determine the optimal treatment regimen for this penile malignancy.
Similar content being viewed by others
References
Kutlubay Z et al (2013) Anogenital malignancies and premalignancies: facts and controversies. Clin Dermatol 31(4):362–373
Krieg RM, Luk KH (1981) Carcinoma of penis. Review of cases treated by surgery and radiation therapy 1960–1977. Urology 18(2):149–154
Graham JH, Helwig EB (1973) Erythroplasia of Queyrat. A clinicopathologic and histochemical study. Cancer 32(6):1396–1414
Horenblas S et al (2000) Squamous cell carcinoma of the penis: premalignant lesions. Scand J Urol Nephrol Suppl 205:187–188
Mikhail GR (1980) Cancers, precancers, and pseudocancers on the male genitalia. A review of clinical appearances, histopathology, and management. J Dermatol Surg Oncol 6(12):1027–1035
Calista D (2002) Topical cidofovir for erythroplasia of Queyrat of the glans penis. Br J Dermatol 147(2):399–400
Harrington KJ et al (1993) Erythroplasia of Queyrat treated with isotretinoin. Lancet 342(8877):994–995
Goette DK, Carson TE (1976) Erythroplasia of Queyrat: treatment with topical 5-fluorouracil. Cancer 38(4):1498–1502
Hadway P, Corbishley CM, Watkin NA (2006) Total glans resurfacing for premalignant lesions of the penis: initial outcome data. BJU Int 98(3):532–536
von Krogh G, Horenblas S (2000) The management and prevention of premalignant penile lesions. Scand J Urol Nephrol Suppl 205:220–229
Micali G, Nasca MR, De Pasquale R (2006) Erythroplasia of Queyrat treated with imiquimod 5% cream. J Am Acad Dermatol 55(5):901–903
Alessi SS et al (2009) Treatment of cutaneous tumors with topical 5% imiquimod cream. Clinics (Sao Paulo) 64(10):961–966
Feldmeyer L et al (2011) Methylaminolaevulinic acid photodynamic therapy in the treatment of erythroplasia of Queyrat. Dermatology 223(1):52–56
Arlette JP (2003) Treatment of Bowen’s disease and erythroplasia of Queyrat. Br J Dermatol 149(Suppl 66):43–49
Orengo I, Rosen T, Guill CK (2002) Treatment of squamous cell carcinoma in situ of the penis with 5% imiquimod cream: a case report. J Am Acad Dermatol 47(4 Suppl):S225–S228
Micali G et al (2010) Treating skin cancer with topical cream. Expert Opin Pharmacother 11(9):1515–1527
Del Losada JP et al (2005) Erythroplasia of Queyrat with urethral involvement: treatment with carbon dioxide laser vaporization. Dermatol Surg 31(11 Pt 1):1454–1457
Zarrabi A, Gross AJ (2011) The evolution of lasers in urology. Ther Adv Urol 3(2):81–89
Manner H et al (2007) The tissue effect of second generation argon plasma coagulation (VIO APC) in comparison to standard APC and Nd:YAG laser in vitro. Acta Gastroenterol Belg 70(4):352–356
Yamagami T et al (1984) Extent of thermal penetration of Nd-YAG laser—histological considerations. Neurosurg Rev 7(2–3):165–170
van Bezooijen BP et al (2001) Laser therapy for carcinoma in situ of the penis. J Urol 166(5):1670–1671
Kennedy JC, Pottier RH, Pross DC (1990) Photodynamic therapy with endogenous protoporphyrin IX: basic principles and present clinical experience. J Photochem Photobiol B 6(1–2):143–148
Lee MR, Ryman W (2005) Erythroplasia of Queyrat treated with topical methyl aminolevulinate photodynamic therapy. Australas J Dermatol 46(3):196–198
Rosemberg SK, Fuller TA (1980) Carbon dioxide rapid superpulsed laser treatment of erythroplasia of Queyrat. Urology 16(2):181–182
Rosemberg SK (1985) Carbon dioxide laser treatment of external genital lesions. Urology 25(6):555–558
Greenbaum SS et al (1989) Carbon dioxide laser treatment of erythroplasia of Queyrat. J Dermatol Surg Oncol 15(7):747–750
Ross BS et al (1998) Squamous cell carcinoma of the penis in a circumcised man: a case for dermatology and urology, and review of the literature. Cutis 61(1):41–43
Conejo-Mir JS et al (2005) Carbon dioxide laser treatment of erythroplasia of Queyrat: a revisited treatment to this condition. J Eur Acad Dermatol Venereol 19(5):643–644
Yamaguchi Y., et al. A case of erythroplasia of Queyrat successfully treated with combination carbon dioxide laser vaporization and surgery. J Eur Acad Dermatol Venereol 2014.
Stables GI et al (1999) Erythroplasia of Queyrat treated by topical aminolaevulinic acid photodynamic therapy. Br J Dermatol 140(3):514–517
Varma S, Holt PJ, Anstey AV (2000) Erythroplasia of queyrat treated by topical aminolaevulinic acid photodynamic therapy: a cautionary tale. Br J Dermatol 142(4):825–826
Paoli J et al (2006) Penile intraepithelial neoplasia: results of photodynamic therapy. Acta Derm Venereol 86(5):418–421
Wang XL et al (2008) Treatment of skin cancer and pre-cancer using topical ALA-PDT—a single hospital experience. Photodiagnosis Photodyn Ther 5(2):127–133
Fai D et al (2012) Methyl-aminolevulinate photodynamic therapy for the treatment of erythroplasia of Queyrat in 23 patients. J Dermatolog Treat 23(5):330–332
Park JY, Kim SJ, Kim YC (2012) Erythroplasia of Queyrat refractory to photodynamic therapy. Clin Exp Dermatol 37(7):795–797
Calzavara-Pinton PG et al (2013) A retrospective analysis of real-life practice of off-label photodynamic therapy using methyl aminolevulinate (MAL-PDT) in 20 Italian dermatology departments. Part 2: oncologic and infectious indications. Photochem Photobiol Sci 12(1):158–165
Cinotti E et al (2014) Laser photodynamic treatment for in situ squamous cell carcinoma of the glans monitored by reflectance confocal microscopy. Australas J Dermatol 55(1):72–74
Nouri K. Lasers in Dermatology and Medicine; 2012. doi:10.1007/978-0-85729-281-0.
Marmur ES, Schmults CD, Goldberg DJ (2004) A review of laser and photodynamic therapy for the treatment of nonmelanoma skin cancer. Dermatol Surg 30(2):264–271
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding sources
None
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Maranda, E.L., Nguyen, A.H., Lim, V.M. et al. Erythroplasia of Queyrat treated by laser and light modalities: a systematic review. Lasers Med Sci 31, 1971–1976 (2016). https://doi.org/10.1007/s10103-016-2005-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10103-016-2005-9