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PubMed1997

[Detecting HPV DNA in tissue of epidermal neoplasms].

Fifty-eight cases (mean age 56.1 +/- 17.1 years) of cutaneous squamous cell carcinoma were studied, including 17 cases of Bowen's disease, 5 cases of Queyrat erythroplasia, 16 cases of Bowenoid papulosis and 20 cases of invasive cutaneous squamous cell carcinoma. All cases were confirmed by pathological findings. HPV6, 11, 16, 18 DNA were detected by multiple pair primers polymerase chain reaction in paraffin-embedded tissues. The results showed that 2(2/17) cases of Bowen's disease, 1 case of Queyrat erythroplasia and 9(9/16) cases of Bowenoid papulosis were positive for HPV16 DNA and that 20 cases of invasive cutaneous sqamous cell carcinoma were negative for HPV16 DNA. HPV16 is closely associated with Bowenoid papulosis and HPV16 might be a factor of multistep carcinogenesis in rare cases of Bowen's disease and Queyrat erythroplasia.

Adult↗
PubMed1999

Penile cancer among patients with genital lichen sclerosus.

BACKGROUND: Genital lichen sclerosus (LS) has sporadically been reported to be associated with penile squamous cell carcinoma (SCC). OBJECTIVE: The purpose of this study was to assess the risk of malignant degeneration in a series of male patients affected by genital LS. METHODS: All cases of histologically proven epithelial malignancy associated with penile LS recorded in our pathology files over a 10-year period (1987-1997) were reviewed. Assessment for presence of human papillomavirus (HPV) was performed from paraffin-embedded tissues using polymerase chain reaction (PCR). RESULTS: Five of 86 white and uncircumcised men with genital LS (mean age at diagnosis, 53 years; range, 22-83 years) showed malignant or premalignant histopathologic features: 3 had SCC, one had erythroplasia of Queyrat (unifocal SCC in situ), and one verrucous carcinoma. The average lag time from onset of LS was 17 years (range, 10-23 years). Histologically, transition from LS to frank neoplastic foci was evident in all cases of SCC. In these SCC cases, areas of epithelial dysplasia were well evident at the tumor periphery. In the remaining cases, the histologic findings were consistent with erythroplasia of Queyrat and verrucous carcinoma. PCR detected HPV 16 infection in 4 of the 5 cases; one SCC patient was negative for HPV. CONCLUSION: Malignant changes were associated with 5.8% of the cases of penile LS in our series. Therefore patients with genital LS are at considerable risk of the development of penile SCC, as well as other epithelial and in situ carcinomas, namely verrucous carcinoma and erythroplasia of Queyrat. HPV infection probably plays a major role because 4 of 5 patients were positive for HPV. Histologically, epithelial dysplasia may represent a precancerous stage before the development of neoplasia in atrophic nonproliferative LS lesions, as its presence at the tumor periphery in our SCC biopsy samples seemed to suggest.

Adult↗
PubMed1985

Carbon dioxide laser treatment of external genital lesions.

Our entire clinical experience with the use of carbon dioxide (CO2) laser in the treatment of 67 patients with diverse external genital lesions is presented. Successful eradication was accomplished in 61 patients with wide distribution of condylomatous lesions, with 88 per cent responding to a single laser treatment. Excellent cosmetic results, as well as complete disappearance of balanitis xerotica obliterans and erythroplasia of Queyrat, were observed in 5 additional patients. Laser therapy, although not an established treatment option, appears to be a safe alternative and should be considered in those patients with recurrent genital condylomata, balanitis xerotica obliterans, as well as erythroplasia of Queyrat, not responding to well-known treatment modalities.

Adolescent↗
PubMed1994

Carcinoma in situ of the penis.

Bowen's disease, erythroplasia of Queyrat and bowenoid papulosis are uncommon disorders of the anogenital skin that may be confused with a variety of other lesions. While all appear histologically as carcinoma in situ and are strongly associated with human papillomavirus infection, only Bowen's disease and erythroplasia of Queyrat have been demonstrated to lead to the development of invasive squamous cell carcinoma. In contrast, bowenoid papulosis has a completely benign course with no present evidence suggesting the potential for malignant degeneration. The standard treatment for all 3 lesions in surgical excision, although use of the carbon dioxide or neodymium:YAG laser appears to be effective at obtaining local control of disease while achieving an excellent cosmetic result. Alternative treatments with micrographic surgery, topical 5-fluorouracil or radiotherapy have a more limited role. It is important to remember that adequate biopsies are always necessary to ensure a complete and accurate diagnosis, and allow for proper treatment and followup, as well as appropriate counseling of sexual partners.

Bowen's Disease↗
PubMed2001

[Precancerous lesions of the buccal mucosa].

OBJECTIVES: We analyzed data in the literature in comparison with experience at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of la Salpêtrière Hospital on precancerous lesions of the oral mucosa, in order to establish definitions and describe epidemiological, clinical, histological findings as well as natural history and treatment outcome. MATERIAL AND METHODS: Three literature sources were analyzed: Medline and Current Contents searches, books and references listed in articles. The following key words were used and classed into three groups; 1) oral mucosa, epidemiology, precancerous lesions, malignant transformation, dysplasia, leucoplakia, oral lichen planus, erythroplasia, verrucous, cheilitis, candidosis, immunodepression, 2) oral mucosa, tumor markers, carcinogens, keratin, keratinocytes, gene, nuclear proteins, p53 protein, Ki-67 antigen, 3) oral mucosa, therapy, prevention, nutrients. The period chosen ran from 1980 to 1998. This automatic literature search was completed by systematic manual search of summaries in specialized journals published in 1997-1998. The lists of references in the identified articles were consulted and furnished the principal publications concerning precancerous lesions of the buccal mucosa. In all 383 references were selected and analyzed by level of scientific proof. Among these 135 are cited in the text. If data in the literature were insufficient, the physicians at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of La Salpêtrière Hospital were consulted to provide their experience-based recommendations. RESULTS AND DISCUSSION: Clear and practical definitions drawn from current knowledge were adopted. Precancerous lesions were distinguished from precancerous states. Precancerous lesions included chronic lesions of the oral cavity on which cancer of the oral cavity is known to develop. These were: leucoplakia, oral lichen planus, erythroplasia, papillomatous lesions, actinic cheilitis, submucosal fibrosis, keratotic candidosis, and tertiary syphilis. The precancerous states included cancers occasionally observed in the oral cavity: immunodepression and Plummer Vinson syndrome were analyzed. Epidemiological, clinical, histological, and evolutive data as well as therapeutic strategies were described. A decisional algorithm was elaborated for leucoplakia. The text was enriched with images available in the Department. CONCLUSION: Precancerous lesions of the oral mucosa offer a particularly interesting area of research for understanding the process of cancer formation and its prevention. The level of scientific proof available in the large majority of the published reports is low. Few recent publications provide relevant data. In practice, the experience in the management of cancer and precancerous lesions of the oral mucosa accumulated over the last 40 years at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of la Salpêtrière Hospital provides an invaluable source of information.

Biomarkers, Tumor↗
PubMed2003

[Detecting HPV DNA in tissues of external genital squamous cell carcinoma in situ by PCR-RFLP technique].

OBJECTIVE: To study the relationship between the infection of human papillomavirus (HPV) and external genital squamous cell carcinoma in situ. METHODS: HPV DNA was detected with the consensus primer by polymerase chain reaction (PCR) and its type was determined by restriction fragment length polymorphism (RFLP). RESULTS: HPV DNA was detected and HPV16 was the most frequently identified type in 29 (56.9%) of 51 cases of external genital squamous cell carcinoma in situ. HPV DNA was positive in 22 (55%) of 40 cases of bowenoid papulosis, among which 20 were of HPV16 type, one of HPV31 type, and one of HPV6 + 16 type. HPV DNA was positive in all 5 cases (100%) of Bowen's disease, among which 4 were HPV16 type and one of HPV6 + 16 type. HPV DNA was positive in 2 (33.3%) of 6 Queyrat erythroplasia cases and all were of HPV16 type. CONCLUSION: HPV16 infection is strongly associated with the external genital squamous cell carcinoma in situ including bowenoid papulosis, Bowen's disease, and Queyrat erythroplasia.

Adult↗
PubMed2005

Bowen's disease involving the urethra.

Bowen's disease developing on mucous or mucocutaneous regions is clinically called erythroplasia of Queyrat. We report herein a 56-year-old male with Bowen's disease extending from the penis shaft to the glans penis, and urethral meatus. Physical examination revealed bright red velvety plaques on the prepuce and glans penis and an irregularly pigmented scaly lesion on the dorsum of his penis shaft. Histopathological findings of both lesions were compatible with those of Bowen's disease, supporting the concept that erythroplasia of Queyrat and Bowen's disease should be regarded as one clinicopathologic entity. A partial penectomy was finally performed, because tumor cells were pathologically observed in the mucous epithelium of the urethra. Although several therapeutic modalities exist for Bowen's disease on the external genitalia, treatment options are limited when Bowen's disease extends to the urethral meatus. We discussed the recent therapeutic modalities in genital Bowen's disease.

Biopsy, Needle↗
PubMed1992

Premalignant lesions and nonsquamous malignancy of the penis and carcinoma of the scrotum.

Premalignant lesions of the penis include cutaneous horn, balanitis xerotica obliterans, and leukoplakia. The true incidence of progression of each of these to squamous-cell carcinoma is unknown. Bowenoid papulosis, erythroplasia of Queyrat, and Bowen's disease are histologically identical to in situ carcinoma. Although the first is consistently benign, the latter two regularly evolve into invasive cancer. Malignant scrotal lesions include squamous-cell carcinoma, liposarcoma, leiomyosarcoma, basal-cell carcinoma, extramammary Paget's disease, erythroplasia of Queyrat, malignant melanoma, and metastases. Hemangioma can be confused with carcinoma.

Carcinoma↗
PubMedDate not supplied

[Precancerous conditions of the oral cavity. Note II--Pathology and clinical course. Critical review of the literature].

The authors examine some specific forms of precancerous states of the oral cavity, selecting them from among the 4 classes defined by the WHO Collaborating Centre for Oral Precancerous Lesions. The immunological system is given particular emphasis. In fact, as studies progress, it appears to be more and more involved not only in the increase in the incidence of such pathologies, but also in the most difficult, if not unknown, genesis of these pathologies. Highly significant examples of this involvement are: Kaposi's Sarcoma, Hairy Cell Leukoplakia, Lichen and Mycoses. Particularly significant aspects for Erythroplasia consist in the following: slow development, frequent and rapid changes in the clinical aspects and its strict connection with Bowen's Disease and Queirat's Erythroplasia. The latter lend further confirmation of its definite precancerous nature and as such, it requires radical surgical treatment. Compared to other forms, the Epidemic variety of Kaposi's sarcoma more frequently affects the oral-salivary glands and structures, the lymph nodes and the laterocervical area. Together with non-Hodgkin tumors, this represents the class of neoplasms most frequently occurring in subjects affected by AIDS. Its "atypical" aggressiveness involves the liver and pancreas and develops over much shorter time periods than the other varieties. In any case, when possible, the treatment required is the excision of the lesions. Neither radiation therapy nor polychemotherapy have yielded encouraging results as yet. In the case of Leukoplakia, it should be kept in mind that today, this pathology is defined "negatively" be exclusion that is the condition must exist that this lesion cannot be clinically or pathologically defined as another lesion. It thus follows that the clinician must maintain an extremely cautious approach in such cases. As concerns prognosis, particular attention should be given to raised, hardened, irregular and fissured forms, which manifest the greatest degenerative capacity. for the classic forms, the treatment adopted is complete exeresis, whereas the use of antiviral drugs is recommended for Hairy Cell Leukoplakia. Lichen Ruber Planus is a papuliferous eruption that is relatively common and affects the skin and mucosa often exclusively involving the oral cavity in the great majority of cases. Besides the clinical picture, the diagnosis of this disease is based on the triad consisting of hyperkeratosis, destruction of the cells of the stratum basale and subepithelial lymphocyte infiltration at distinctly low levels. In uncertain cases, however, the detection of Fluorescent Bodies grouped in large clusters near the hyaline membrane, acquires particular importance for the specification of the diagnosis.

Candidiasis, Oral↗
PubMed1986

Bowenoid papulosis. A clinicopathologic study with ultrastructural observations.

One hundred eight patients were studied who had anogenital lesions showing microscopic features as seen in bowenoid papulosis (BP), a recently described condition occurring most commonly in young adults. Patients typically show multiple papules, small nodules, or plaques that clinically mimic verrucae or nevocellular nevi. Although the lesions show microscopic cytologic atypia, a distinction from Bowen's disease, erythroplasia of Queyrat, and other forms of carcinoma in situ can usually be made on the basis of histologic and clinical criteria. The disorder responds to conservative treatment, although recurrences are not uncommon. Evolution of the lesions to invasive carcinoma was not observed. Mounting evidence links the development of BP to infection with human papilloma virus, but other viruses, as well as hormonal and immunologic factors, may also play a role.

Adolescent↗
PubMed1981

Bowenoid papulosis of the penis.

Bowenoid papulosis of the penis is a recently emerged entity that clinically resembles benign dermatosis but it is histologically identical to pre-invasive carcinoma. Its lesions are multiple, painless and wart-like in appearance, and occur in young, circumcised men between 21 and 38 years old. Therapy consists of excision, electrodissection or topical 5-fluorouracil. We report 2 cases of bowenoid papulosis of the penis and compare this entity to Bowen's disease, erythroplasia of Queyrat and invasive carcinoma.

Adult↗
PubMed1977

Malignant penile horn.

The fifth case of carcinoma within a penile horn is reported in a patient who also had erythroplasia of Queyrat of the glans penis. Penile horns should be considered as pre-malignant lesions, since a third of them undergo malignant change and they may be associated with a pre-malignant condition of the glans penis.

Carcinoma in Situ↗
PubMed2002

Penile intraepithelial neoplasia: clinical spectrum and treatment of 35 cases.

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).

Adult↗
PubMed1985

[Dystrophy and precancerous changes in the vulva: symptoms, histology and therapy].

The article reports about the relatively rare diseases kraurosis vulvae (lichen sclerosus et atrophicus) and leucoplakia vulvae and the symptoms, aetiology, histology and therapy of these diseases. Both diseases are considered to be a "dystrophy" since 1976, by international convention. This publication is a report on 168 patients treated during the last 20 years (1964-1983). 34 patients suffered from diabetes mellitus (21%); 73.2% of the women were aged between the 61st and 90th year of life. 15 women already had an incipient vulvar carcinoma besides kraurosis (8.9%). Precancerous alterations, such as morbus Bowen (29 cases), morbus Paget of the vulva (6 cases), and erythroplasia of Queyrat are subsequently discussed.

Adult↗
PubMed1980

Cancers, precancers, and pseudocancers on the male genitalia. A review of clinical appearances, histopathology, and management.

Leukoplakia penis and balanitis xerotica obliterans are precancerous lesions. Bowen's disease, erythroplasia (Queyrat), and extramammary Paget's disease are carcinomas in situ. Lesions of both types may closely mimic benign skin conditions that may occur in the genital region. Histologic examination is usually the only certain means of diagnosis. The same considerations apply to pseudomalignancies, e.g., giant condyloma acuminatum (Buschke-Loewenstein), which clinically behaves as a carcinoma but histologically appears benign, and Bowenoid papulosis, a new entity that is believed to be benign although it has histologic features of a carcinoma in situ.

Balanitis↗
PubMed1964

NON-INFECTIOUS INFLAMMATORY AND NEOPLASTIC DISORDERS OF THE MALE GENITALIA.

The cutaneous manifestations of the male external genitalia are difficult to diagnose. They may be associated with systemic disease (Reiter's disease, psoriatic arthritis, angiokeratoma corporis diffusum). In dealing with a lesion of this area that does not heal, adequate biopsy is advisable to rule out malignant disease (Bowen's disease, melanoma, Kaposi's sarcoma, Paget's disease, erythroplasia).

Anus Neoplasms↗
PubMed1992

Conservative extirpative treatment of cancer of the penis.

Carcinoma in situ, erythroplasia of Queyrat, and Bowen's disease have been managed successfully with a variety of conservative techniques. The management of invasive carcinoma remains controversial. The goal of surgical treatment in these patients is complete excision of the tumor with adequate tumor-free margins. While partial or total penile amputation is necessary for complete eradication of some primary penile tumors, many patients can be managed adequately with optimal preservation of function. Young and reliable patients with well-differentiated tumors are the most suitable candidates for conservative surgical extirpation.

Carcinoma in Situ↗
PubMed1977

[X-ray irradiation of dermatoses in the genital area].

Report on empirical data of X-ray treatment of dermatoses in the genital area, concerning indications, technique and results. Irradiations are mainly successful in large patches of Bowen's disease and Bowen's carcinoma as well as in Queyrat's erythroplasia and Paget's disease. Carcinomata of the penis should not exceed the stages T1-T2. Regression of Peyronie's disease is accelerated. Psoriatic lesions disappear following Grenz-rays without further topical treatment. Grenz-rays can also prevent or delay local recurrences of herpes simplex eruptions in the genital area.

Aged↗