Erythroplasia of Queyrat (Bowen Disease of the Glans Penis) Treatment & Management

Updated: Nov 07, 2019
  • Author: Vikas Shrivastava, MD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

Cases of erythroplasia of Queyrat (EQ) have been treated with the following:

  • 5-Fluorouracil [16, 17]  - Limited success

  • Imiquimod [18, 19, 20, 21, 22]  - Variable response with limited data on long-term efficacy

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Surgical Care

Surgical treatments for erythroplasia of Queyrat include the following [23] :

  • Mohs micrographic surgery [1, 24, 25, 26] : Five-year cure rate up to 90% [1]

  • Surgical excision [4] : Recurrence rate of 2% for total glansectomy [9] ; penis preserving strategies recommended for small lesions [6, 9] ; may include partial glansectomy and circumcision with skin grafting [6]

  • Cryotherapy

  • Electrodesiccation and curettage

  • Radiation

  • Carbon dioxide laser ablation [27, 28, 29]

  • Nd:YAG laser ablation [30]

  • Photodynamic therapy with aminolevulinic acid: Multiple treatments may be required for clearance [31]

  • Photodynamic therapy with methyl-aminolevulinate: Multiple treatments may be required for clearance [32] ; studies have shown up to 83% of patients with clinical remission, [33, 34] but rates as low as 27% reported (2011) [25] ; may lead to preservation of function and good cosmesis [25] ; may be used in cases of recurrence or if surgery not desired [25] ; adverse effects include redness, burning, pain, swelling, dysuria, ulceration, blistering, and pigment changes [25, 33]

Circumcision is recommended. [6]

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Long-Term Monitoring

Close follow-up is recommended for patients treated medically or surgically. [35]

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