Erythroplasia of Queyrat (Bowen Disease of the Glans Penis) 

  • Author: Kendall M Egan, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Oct 18, 2010
 

Background

Erythroplasia of Queyrat (Bowen disease of the glans penis) originally was described by Tarnovsky in 1891 and subsequently was appreciated as a penile disease by Fournier and Darier in 1893. More intensive studies by Queyrat in 1911 allowed erythroplasia of Queyrat to be accepted as a distinct entity. Sulzberger and Satenstein in 1933 recognized erythroplasia of Queyrat to be a form of carcinoma in situ.[1]

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Pathophysiology

Erythroplasia of Queyrat (Bowen disease of the glans penis) arises from the mucocutaneous epithelium of the penis. The glans and prepuce are most commonly involved. Erythroplasia of Queyrat is seen almost exclusively in uncircumcised men and represents an in situ form of squamous cell carcinoma. Progression to invasive carcinoma may occur after a variable period in 10-33% of cases.[2] Of note, progression to squamous cell carcinoma is more common in erythroplasia of Queyrat than in other forms of Bowen disease of the penis.

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Epidemiology

Frequency

United States

Erythroplasia of Queyrat (Bowen disease of the glans penis) is a rare disorder in the United States. The exact prevalence of erythroplasia of Queyrat is not well reported in the medical literature.

Mortality/Morbidity

The cure rate for erythroplasia of Queyrat (Bowen disease of the glans penis) is high if erythroplasia of Queyrat lesions are identified and treated early.

Malignant transformation is possible within erythroplasia of Queyrat lesions and could affect prognosis if present. Special attention should be given to ulcerative or verrucous changes within erythroplasia of Queyrat lesions, and a histological evaluation should be obtained, because these could signify invasive malignancy. In one case series review, Graham and Helwig described 10% of erythroplasia of Queyrat cases progressing to malignant disease.[3] Several case reports of erythroplasia of Queyrat metastasis to local lymph nodes have been reported.[4]

Sex

Erythroplasia of Queyrat (Bowen disease of the glans penis) occurs in males, most commonly uncircumcised males.

Age

The median age of onset is 51 years. Erythroplasia of Queyrat (Bowen disease of the glans penis) has been described in males ranging from age 20-80 years.[3]

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Proceed to Clinical Presentation
 
 
Contributor Information and Disclosures
Author

Kendall M Egan, MD  Resident Physician, Department of Dermatology, Naval Medical Center San Diego

Kendall M Egan, MD is a member of the following medical societies: American Academy of Dermatology, California Society of Dermatology and Dermatologic Surgery, and Pacific Dermatologic Association

Disclosure: Nothing to disclose.

Coauthor(s)

Kimberly L Maino, MD  Head, Dermatologic Surgery/Oncology, Mohs Micrographic Surgery, Department of Dermatology, Naval Medical Center San Diego

Kimberly L Maino, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Medical Association, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mark W Cobb, MD  Consulting Staff, WNC Dermatological Associates

Mark W Cobb, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and American Society of Dermatopathology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Mary Farley, MD  Dermatologic Surgeon/Mohs Surgeon, Anne Arundel Surgery Center

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Goette DK. Review of erythroplasia of Queyrat and its treatment. Urology. Oct 1976;8(4):311-5. [Medline].

  2. Micali G, Innocenzi D, Nasca MR, Musumeci ML, Ferrau F, Greco M. Squamous cell carcinoma of the penis. J Am Acad Dermatol. Sep 1996;35(3 Pt 1):432-51. [Medline].

  3. Graham JH, Helwig EB. Erythroplasia of Queyrat. A clinicopathologic and histochemical study. Cancer. Dec 1973;32(6):1396-414. [Medline].

  4. Kim B, Garcia F, Toma N, et al. A rare case of penile cancer in siu metastasizing to lymph nodes. Can Urol Assoc J. 2007;1:404-7.

  5. Divakaruni AK, Rao AV, Mahabir B. Erythroplasia of Queyrat with Zoon's balanitis: a diagnostic dilemma. Int J STD AIDS. Dec 2008;19(12):861-3. [Medline].

  6. 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. Sep 2000;115(3):396-401. [Medline].

  7. Harrington KJ, Price PM, Fry L, Witherow RO. Erythroplasia of Queyrat treated with isotretinoin. Lancet. Oct 16 1993;342(8877):994-5. [Medline].

  8. Micali G, Nasca MR, De Pasquale R. Erythroplasia of Queyrat treated with imiquimod 5% cream. J Am Acad Dermatol. Nov 2006;55(5):901-3. [Medline].

  9. Conejo-Mir JS, Munoz MA, Linares M, Rodriguez L, Serrano A. Carbon dioxide laser treatment of erythroplasia of Queyrat: a revisited treatment to this condition. J Eur Acad Dermatol Venereol. Sep 2005;19(5):643-4. [Medline].

  10. Arlette JP. Treatment of Bowen's disease and erythroplasia of Queyrat. Br J Dermatol. Nov 2003;149 Suppl 66:43-9. [Medline].

  11. Orengo I, Rosen T, Guill CK. Treatment of squamous cell carcinoma in situ of the penis with 5% imiquimod cream: a case report. J Am Acad Dermatol. Oct 2002;47(4 Suppl):S225-8. [Medline].

  12. Gerber GS. Carcinoma in situ of the penis. J Urol. Apr 1994;151(4):829-33. [Medline].

  13. Brown MD, Zachary CB, Grekin RC, Swanson NA. Genital tumors: their management by micrographic surgery. J Am Acad Dermatol. Jan 1988;18(1 Pt 1):115-22. [Medline].

  14. van Bezooijen BP, Horenblas S, Meinhardt W, Newling DW. Laser therapy for carcinoma in situ of the penis. J Urol. Nov 2001;166(5):1670-1. [Medline].

  15. Lee MR, Ryman W. Erythroplasia of Queyrat treated with topical methyl aminolevulinate photodynamic therapy. Australas J Dermatol. Aug 2005;46(3):196-8. [Medline].

  16. Davis-Daneshfar A, Trueb RM. Bowen's disease of the glans penis (erythroplasia of Queyrat) in plasma cell balanitis. Cutis. Jun 2000;65(6):395-8. [Medline].

  17. Porter WM, Francis N, Hawkins D, Dinneen M, Bunker CB. Penile intraepithelial neoplasia: clinical spectrum and treatment of 35 cases. Br J Dermatol. Dec 2002;147(6):1159-65. [Medline].

 
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Erythroplasia of Queyrat. Courtesy of Hon Pak, MD.
 
 
 
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