Initially described more than 100 years ago, Erythroplasia of Queyrat (EQ) is a distinct clinical entity denoting a pre-cancerous lesion of the squamous cell carcinoma (SCC) in situ of the penis [1] [2]. It is rarely encountered in clinical practice and appears on the penile mucosal surfaces - the glans, coronal sulcus and prepuce, while the urethral meatus is also reported as a potential site [2] [3]. Many studies have classified Bowen's disease (BD) and EQ as the same entity because of their striking similarity on histological examinations, but the different location of BD (mainly seen on the skin of the penile shaft) differentiates the two terms in the majority of literature [2] [3]. Elderly patients are the principal population in whom EQ is diagnosed, and the presence of a phimotic foreskin, as well as an uncircumcised penis, are considered to be risk factors, as they are encountered in the vast majority of patients [1] [3]. The typical presentation involves a well-demarcated, shiny, bright-red, or red velvet-colored patches or plaques (either solitary or multiple) that are painless, although erosions may be noted [1] [2] [3]. However, because these lesions resemble numerous dermatologic conditions (including psoriasis, dermatitis, any of the sexually transmitted infections that present in a similar fashion, lichen planus, Zoon's balanitis, etc), the diagnosis might be initially missed [1] [2] [3] [4] [5].

• Asymptomatic

  Abstract EQ (erythroplasia of Queyrat) manifests itself by single or multiple asymptomatic papules or plaques on the glans penis, or periurethrally, predominantly in uncircumcised men, age range from twenty to eighty years of age. [ncbi.nlm.nih.gov]

  If asymptomatic, it may not require treatment. Topical corticosteroids may help relieve symptoms. [merckmanuals.com]

  A 36-year-old man, with no particular history, presented asymptomatic lesions of the glans for 1 year. [odermatol.com]

• Weakness

  If you have Bowen’s disease, you’re at a higher risk for other types of skin cancers, especially if you have a weak immune system from disease or medical treatments. You should have regular follow-ups and skin checks with your doctor. [webmd.com]

  Symptoms The signs and symptoms of BXO include: a scaly, whitish patch that usually involves the opening of the urethra (meatus) itching or burning loss of sensitivity to the glans painful urination painful erection weak or decreased urine stream discharge [cancer.ca]

  […] condition include: Penile Skin Changes Itching and burning under foreskin Thickening of skin Skin discoloration Lumps Ulcers Rash; velvety red under foreskin Bleeding under foreskin Foul smelling discharge under foreskin Genitourinary Changes Dysuria Weak [wikidoc.org]

   Weakness, weight loss, fatigue, and systemic malaise occur secondary to chronic suppuration.  On occasion, significant blood loss from the penile lesion, the nodal lesion, or both may occur.  Symptoms referable to metastases are rare. 19.  SIGNS [slideshare.net]

• Fever

  Balanitis circinata: erosive plaques with slightly raised edges on the glans due to a Reiter's syndrome. 1–4 weeks after urinary tract infection or intestinal infection patients may develop a Reiter's syndrome: fever, malaise, urethritis (95%), prostatitis [urology-textbook.com]

  It has been reported as a source of fever and bacteraemia in neutropenic men, 3 and candidal balanitis may be especially severe in patients with diabetes mellitus. 4 In a series of 321 patients, the majority (185 patients had an infective cause, although [cirp.org]

• Fatigue

   Weakness, weight loss, fatigue, and systemic malaise occur secondary to chronic suppuration.  On occasion, significant blood loss from the penile lesion, the nodal lesion, or both may occur.  Symptoms referable to metastases are rare. 19.  SIGNS [slideshare.net]

• Ulcer

  Inorganic arsenic ingestion, radiation dermatitis (x-ray damage), immunosuppression or HIV, burn scars, and chronic ulcers are also associated with BD. [mitchmedical.us]

  The bright red lesions may be ulcerated. The disease progresses slowly, and the interval between onset and diagnosis may be years. The cause is unknown. Diagnosis is confirmed only by histologic examination. [ncbi.nlm.nih.gov]

  Early lesions present as an ulcer, nodule or warty growth on the glans or inner surface of the prepuce. More advanced tumors are usually large, ulcerated and fungating. The presence of a prepuce may obscure the tumor until it is well advanced. [med-ed.virginia.edu]

  Ulceration or distinct papillomatous papules within a plaque may indicate progression in invasive squamous cells carcinoma. [journals.lww.com]

• Papule

  This lesion occurs as small papules or macules, sometimes annular, on the glans or shaft and may be mistaken for pemphigoid or erythema multiforme. Pruritus is common. [merckmanuals.com]

  Abstract EQ (erythroplasia of Queyrat) manifests itself by single or multiple asymptomatic papules or plaques on the glans penis, or periurethrally, predominantly in uncircumcised men, age range from twenty to eighty years of age. [ncbi.nlm.nih.gov]

  Ulceration or distinct papillomatous papules within a plaque may indicate progression in invasive squamous cells carcinoma. [journals.lww.com]

• Dermatitis

  However, because these lesions resemble numerous dermatologic conditions (including psoriasis, dermatitis, any of the sexually transmitted infections that present in a similar fashion, lichen planus, Zoon's balanitis, etc), the diagnosis might be initially [symptoma.com]

  الصفحة 516 - Werner Y, Lindberg M: Transepidermal water loss in dry and clinically normal skin in patients with atopic dermatitis. Acta Derm Venereol (Stockh) 1985;65:102-105. ‏ [books.google.com]

  Contact dermatitis of the penis has become more common with the widespread use of latex condoms. Dermatitis appears as red, pruritic lesions, sometimes with weeping or fissures. [merckmanuals.com]

• Erythema

  Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme. Arch Dermatol '1993; 129: 92-6. ‏ [books.google.com]

  Look at other dictionaries: Erythroplasia de Queyrat — Klassifikation nach ICD 10 D07 Carcinoma in situ sonstiger und nicht näher bezeichneter Genitalorgane D07.1 Vulva D07.4 … Deutsch Wikipedia erythroplasia — Erythema and dysplasia of the epithelium [medicine.academic.ru]

  […] intraepithelial neoplasia … Medical dictionary Queyrat erythroplasia — Quey·rat erythroplasia (ka rahґ) [Louis Auguste Queyrat, French dermatologist, 1856–1933] penile intraepithelial neoplasia; see under neoplasia … Medical dictionary erythroplasia — Erythema [translate.academic.ru]

  Balanitis plasmazelluluaris (Zoon's disease): Bright and sharply defined erythema of the glans. The inflammatory lesion of the glans of unknown etiology is rather asymptomatic. Histology shows a plasmacellular infiltrate. [urology-textbook.com]

  Thirty days after the third cycle, the lesion showed complete clinical resolution, displaying only discreet erythema at the distal glans. [ncbi.nlm.nih.gov]

• Skin Disease

  Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 31. Updated by: David L. [nlm.nih.gov]

  However, other more severe diseases such as malignant skin lesions ( erythroplasia of Queyrat ), infectious disease (human papillomavirus-induced penile warts) or systemic skin diseases (psoriasis) may be detected. [glosbe.com]

  It has been used successfully to treat benign, premalignant and malignant skin diseases. We present four patients with EQ who have been treated by topical ALA PDT. [ncbi.nlm.nih.gov]

  disease virology Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. [sti.bmj.com]

  Related Treatment of Skin Disease Comprehensive Therapeutic Strategies 4e [clinicalgate.com]

• Irritability

  Received: 9 March 2012 / Revised: 9 May 2012 / Accepted: 29 May 2012 / Published: 7 June 2012 Abstract A 58-year-old Caucasian male presented to the urology clinic reporting an approximate one-year history of a persistent irritating, slowly progressive [mdpi.com]

  The main symptoms are a rash and irritation on the tip or shaft of the penis that persists. The area is most often red and does not respond to topical creams. [nlm.nih.gov]

  The drug can be used continuously for 4-5 weeks and its side effects include erythema, edema, and local irritation.10 In the present case, we used a two-week treatment cycle because the patient presented significant local irritation at the end of the [ncbi.nlm.nih.gov]

  The early signs of erythroplasia of queyrat can look like mild irritation or a flareup of a sexually transmitted infection. [wisegeek.com]

  Multiple factors have been implicated as causative agents in this process: chronic irritation, inflammation, infection as herpes simplex, humanpapilloma virus, urine, smegma, poor hygiene, trauma, immunosuppression… Characteristic lesions of EQ are solitary [journals.lww.com]

• Penile Lesion

  We have investigated 12 paraffin-embedded biopsies from eight patients with penile erythroplasia of Queyrat and control biopsies of inflammatory penile lesions, of genital Bowen's disease, and of premalignant/malignant cervical or vulvar lesions by 10 [ncbi.nlm.nih.gov]

  Objective : To determine the incidence of penile intraepithelial neoplasia in the Netherlands using a nationwide histopathology registry and to discuss the nomenclature of premalignant penile lesions. [pubfacts.com]

  Stiles Medicine 1934 Although the original descriptions deal with penile lesions, subsequent cases have appeared in which the lesions occurred on the penis and the name, "erythroplasie du gland," has persisted until the present time. [semanticscholar.org]

• Genital Lesions

  Genital lesions in males: Various forms of balanitis, erysipelas, lues stage II, psoriasis and erythroplasia Queyrat are possible differential diagnoses. [glosbe.com]

  Skin: Structure and Functions lesion. The lesion can occur in other areas as well. The genital region, particularly the penile shaft, is also affected. [lecturio.com]

  Sir; Intraepithelial neoplasias (IINs) of the penis are genital lesions defined histologically by the presence of intraepithelial cytologic and architectural atypias. It may progress to invasive squamous cell carcinoma. [odermatol.com]

  CARBON DIOXIDE LASER TREATMENT OF EXTERNAL GENITAL LESIONS SAMUEL K. [cirp.org]

  The overall risk of progression of BD to invasive cancer is about 3% to 5%, However, risk is greater for patients with oral and genital lesions (about 10%), as well as those with a history of arsenic exposure or lesions located in a chronic scar or ulcer [mitchmedical.us]

The importance of recognizing EQ early on lies in the fact that penile in situ squamous cell carcinoma (SCC) can arise from up to a third of patients who develop this lesion and approximately 20% of SCCs develop distant metastases [1] [2] [3] [5]. Furthermore, 5-year survival rates of invasive SCC range from 66%-27%, depending on the stage [6]. For these reasons, a meticulous physical examination of the penis and the genitalia is perhaps essential in recognizing EQ. As the presentation is nonspecific, the initial distinction between Bowen's disease (which is less likely to progress into SCC) and EQ should be made based on the location of the lesion, but a biopsy and subsequent histopathological examination is necessary to rule out other etiologies and confirm EQ as the presenting lesion [4] [5]. Generalized hyperplasia (acanthosis), the presence of parakeratotic cells with hyperchromatic nuclei, focal erosions, dyskeratosis, and dermal infiltration of inflammatory cells are some of the most prominent histopathological findings described in the literature [4] [5].

With these treatment modalities recurrences are not uncommon. Read More Download full-text PDF Source Treatment of erythroplasia of Queyrat with liquid nitrogen cryosurgery. [pubfacts.com]

The treatment is often difficult and associated with significant recurrence rates, especially in cases with urethral involvement. To evaluate carbon dioxide laser treatment in a case of erythroplasia of Queyrat with urethral involvement. [ncbi.nlm.nih.gov]

Carbon dioxide laser treatment of erythroplasia of Queyrat: a revisited treatment to this condition. J Eur Acad Dermatol Venereol. 2005 Sep. 19(5):643-4. [Medline]. Arlette JP. Treatment of Bowen's disease and erythroplasia of Queyrat. [emedicine.com]

Bull Soc Fr Dermatol Syph 22: 378-382 Schmitz L et al (2014) Optical coherence tomography imaging of erythroplasia of Queyrat and treatment with imiquimod 5% cream: a case report. [altmeyers.org]

[…] such as: Mohs micrographic surgery or other surgical procedures to remove the area Laser surgery Freezing the cancer cells ( cryotherapy ) Scraping away cancer cells and using electricity to kill any that remain (curettage and electrodesiccation) The prognosis [nlm.nih.gov]

The prognosis for cure is excellent in most cases. [mountsinai.org]

Of the methods reviewed, the CO 2 laser offered the most promising results with a cosmetically excellent prognosis. [miami.pure.elsevier.com]

If treated, however, the prognosis is excellent. [amboss.com]

[…] nonspecific, the initial distinction between Bowen's disease (which is less likely to progress into SCC) and EQ should be made based on the location of the lesion, but a biopsy and subsequent histopathological examination is necessary to rule out other etiologies [symptoma.com]

Lentigo maligna (LM) Definition : precancerous lesion with intraepithelial proliferation of dysplastic melanocytes Epidemiology : : peak incidence : 70–90 years Etiology : : exposure to UV light Lesion Mostly found in areas exposed to sun (e.g., face, [amboss.com]

Diagnosis In doubt of the etiology or resistance to standard care, a microbiological culture and/or biopsy should be obtained. [urology-textbook.com]

The etiology was unknown, but it is extremely rare in those circumcised in early infancy. It had been suggested that phimosis had some etiologic importance. The typical case of Erythroplasia of Queyrat is presented. [pesquisa.bvsalud.org]

Leukoplakia: Etiology  No etiologic factor can be identified for most persistent oral leukoplakias (idiopathic leukoplakia). [slideshare.net]

NMSC I: Epidemiology – Genetics – Clinical Aspects P45 Erythroplasia Queyrat s.Bowen disease of the glans penis Milosavljevic, M.a; Spalevic, L.J.a; Blazevic-Kamenov, N.b; Pivac-Marinkovic, D.a; Ljubosavljevic, D.a aClinic of Dermatology bPrivate Clinic [journals.lww.com]

"Penile cancer: epidemiology, pathogenesis and prevention". World Journal of Urology. 27 (2): 141–150. doi:10.1007/s00345-008-0302-z. ISSN 0724-4983. ↑ Douglawi, Antoin; Masterson, Timothy A. (2017). [wikidoc.org]

Lentigo maligna (LM) Definition : precancerous lesion with intraepithelial proliferation of dysplastic melanocytes Epidemiology : : peak incidence : 70–90 years Etiology : : exposure to UV light Lesion Mostly found in areas exposed to sun (e.g., face, [amboss.com]

[…] and is usually due to HPV 16 ( Int J Exp Pathol 2009;90:182 ) Bowen disease: clinical designation of carcinoma in situ located in the shaft Erythroplasia of Queyrat: clinical designation of carcinoma in situ located in the glans, usually erythematous Epidemiology [pathologyoutlines.com]

Squamous cell carcinoma Epidemiology In countries with high circumcision rates the incidence of squamous cell carcinoma of the penis is very low and correspondingly more common in countries where the practice is not routine. [med-ed.virginia.edu]

Bowen Classification There is no established classification for Balanitis caused by Penile carcinoma in situ Pathophysiology Pathophysiology of penile carcinoma in situ include: [1] [2] [3] [4] [5] [6] [2] [7] Bowenoid papulosis The exact pathogenesis [wikidoc.org]

Etiology Pathophysiology Bowen’s disease may evolve de novo or from a preexisting actinic keratosis. [dermatologyadvisor.com]

Treatment and Prevention Prevention of EQ in uncircumcised males may be maximized by adherence to good personal hygiene regimens, and early circumcision may also reduce the incidence of this disease. [dermaamin.com]

Prevention There are no established measures for the prevention of erythroplasia of Queyrat. References ↑ Weidner, Noel (2009). Modern surgical pathology. Philadelphia, PA: Saunders/Elsevier. [wikidoc.org]

Primary skin cancer is the most common cancer afflicting mankind and is rising in inci dence, despite the fact that it is often preventable. [books.google.de]

1. Fanning DM, Flood H. Erythroplasia of Queyrat. Clin Pract. 2012;2(3):e63.
2. Choi JW, Choi M, Cho KH. A Case of Erythroplasia of Queyrat Treated with Imiquimod 5% Cream and Excision. Ann Dermatol. 2009;21(4):419-422.
3. Shabbir M, Minhas S, Muneer A. Diagnosis and management of premalignant penile lesions. Ther Adv Urol. 2011;3(3):151-158.
4. Öztürk S, Uçak H. Queyrat erythroplasia accompanied by bladder cancer in a circumcised male. Indian J Med Res. 2014;139(4):650-651.
5. Divakaruni AK, Rao AV, Mahabir B. Erythroplasia of Queyrat with Zoon's balanitis: a diagnostic dilemma. Int J STD AIDS. 2008;19(12):861-863.
6. Aster JC, Abbas AK, Robbins SL, Kumar V. Robbins basic pathology. Ninth edition. Philadelphia, PA: Elsevier Saunders; 2013.