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.


OBJECTIVE
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).
Porter
W M
WM
Department of Dermatology, Chelsea and Westminster Hospital, Imperial College School of Medicine, London SW10 9NH, UK. William.Porter@gloucr-tr.swest.nhs.uk
Francis
N
N
Hawkins
D
D
Dinneen
M
M
Bunker
C B
CB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001913:Bowen's Disease / Q000473:pathology* / Q000628:therapy / Q000821:virology; D002278:Carcinoma in Situ / Q000473:pathology* / Q000628:therapy / Q000821:virology; D002944:Circumcision, Male; D004919:Erythroplasia / Q000473:pathology / Q000628:therapy / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications; D010412:Penile Neoplasms / Q000473:pathology* / Q000628:therapy / Q000821:virology; D012307:Risk Factors; D016896:Treatment Outcome; D014412:Tumor Virus Infections / Q000150:complications