Erythroplasia of Queyrat (Bowen Disease of the Glans Penis) Workup

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

Laboratory Studies

The diagnosis of erythroplasia of Queyrat (EQ) is made via histological examination. Specifically, biopsy should be performed on any areas with signs of bleeding, ulceration, or papillomatous change. [6] Additionally, biopsy should be performed on therapy-resistant lesions. [1] The following diagnostic procedures may be useful in excluding other infectious processes:

  • Tzanck preparation

  • Bacterial/viral/fungal culture

  • Potassium hydroxide examination

  • Gram stain

Early invasive disease should be evaluated for with several biopsies as needed. [6] Failure to carefully evaluate any patient, especially uncircumcised patients, presenting with a subacute or chronic balanitis is a potential medicolegal pitfall. The threshold for performing skin biopsy of any lesion should be very low. In addition, a failure to diagnose erythroplasia of Queyrat expediently can easily result in disease that progresses to frank squamous cell carcinoma of the penis.

Some authors have also called for optical coherence tomography in conjunction with skin biopsy. [15]

 

 

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Histologic Findings

Histologic findings include the following [14, 9] :

  • Epidermal acanthosis, parakeratosis

  • Partial- or full-thickness epidermal atypia

  • Possible dyskeratosis

  • Possible lymphohistiocytic dermal infiltrate

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