Intraepithelial neoplasm of the penis

What is penile intraepithelial? neoplasm?

Penile intraepithelial neoplasia is a rare precancerous disease of the outer layer of the skin (epidermis) of the penis.

Other names for penile intraepithelial neoplasia include:

• Scaly intraepithelial injury
• Queyrat erythroplasia
• Bowen's disease of the penis
• in the place squamous cells carcinoma penis
• PIN.

How is penile intraepithelial neoplasia recognized?

The diagnosis is often delayed, because penile intraepithelial neoplasia can resemble other conditions, such as balanitis, yeast infection, dermatitis and psoriasis

Lesions are single or multiple, red plates on the glans penis or on the inner aspect of the prepuce. They may appear soft, velvety, moist, scaly, eroded or warty surface. The following signs and symptoms may appear:

• redness and inflammation
• itching
• Crust or climbing
• Pain
• Ulcers
• Bleeding
• In the last stages, download penis, difficulty pulling back the foreskin, or difficulty urinating

Penile Intraepithelial Neoplasia Imaging

Who is at risk for penile intraepithelial neoplasia and what causes it?

Uncircumcised men over the age of 50 are at higher risk of penile intraepithelial neoplasia, although it can rarely occur in younger men.

Penile intraepithelial neoplasia is associated with:

• Chronic infection with the human papillomavirus (HPV), the cause of genital warts. HPV-16 is the most common type identified.
• Chronic skin disease, especially lichen sclerosus and lichen planus
• Of smoking
• Immunosuppression due to medication or illness
• Chronic irritation from urine, friction, or injury to the penile area.

If left untreated, the 10-30% cases become invader squamous cell carcinoma (Cancer) of the penis.

What is the treatment for penile intraepithelial neoplasia?

Skin biopsy it should be performed to confirm the diagnosis, as it may resemble other forms of chronic balanitis. A biopsy is also essential to rule out invasive squamous cell carcinoma, which requires more aggressive treatment.

It is important to maintain good genital hygiene. Penile intraepithelial neoplasia can be treated in several different ways. Multidisciplinary care may be necessary.

• 5-fluorouracil cream
• Imiquimod cream
• Cryotherapy
• curettage and cauterization
• To be vaporization
• Photodynamic therapy
• Radiotherapy
• Excision
• Alpha interferon

Mohs micrographic surgery seems to be highly effective and the surgical treatment of choice in severe or recurrent cases of penile intraepithelial neoplasia.

The disease recurs in 3 to 10% of patients, so careful follow-up is necessary to ensure complete cure.

Partners of patients with penile intraepithelial neoplasia should be examined for other forms of HPV-caused intraepithelial neoplasia in the genital area (cervical, vulvar, and anal cancer).

Many national immunization programs now include a vaccine against the HPV-16 and 18-causing human papillomaviruses. Vaccination of boys and young men should be included to reduce the risk of developing penile intraepithelial cancer in the future. Men with penile intraepithelial neoplasia are sometimes treated with the HPV vaccine; their effectiveness In this situation is unknown.