RESUMEN
INTRODUCTION: Penile intra-epithelial neoplasia (PIN) are precancerous lesions, characterized by architectural and cytological abnormalities of the genital epithelium, from which can arise squamous carcinomas. METHODS: A literature review was performed on the Medline database, considering the articles listed between October 2007 and October 2017 dealing with PIN, using the following keywords "intraepithelial neoplasia" or "Bowen's disease" or "erythroplasia of Queyrat" or "bowenoid papulosis" and "penis ¼. Papers were selected according to their language (English and French) and their relevance. RESULTS: One hundred seventy four articles related to PIN were listed. Twenty-five of them were selected for their relevance. The analysis of the references of these articles identified 6 relevant papers published before October 2007, which were considered for this review based on a total of thirty-one articles. We describe clinical and pathological characteristics of PIN, emphasizing treatment modalities. CONCLUSION: Urologists should distinguish HPV-related and non HPV-related PIN, both of them sharing clinical presentation, but needing different management.
Asunto(s)
Enfermedad de Bowen/diagnóstico , Carcinoma in Situ/diagnóstico , Neoplasias del Pene/diagnóstico , Enfermedad de Bowen/patología , Enfermedad de Bowen/terapia , Carcinoma in Situ/patología , Carcinoma in Situ/terapia , Humanos , Masculino , Infecciones por Papillomavirus/complicaciones , Neoplasias del Pene/patología , Neoplasias del Pene/terapia , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/terapiaAsunto(s)
Enfermedades del Pene/patología , Pene/patología , Antiinflamatorios/uso terapéutico , Clobetasol/uso terapéutico , Desbridamiento , Humanos , Hiperplasia , Láseres de Gas/uso terapéutico , Masculino , Enfermedades del Pene/tratamiento farmacológico , Enfermedades del Pene/cirugía , Lesiones Precancerosas/tratamiento farmacológico , Lesiones Precancerosas/patología , Lesiones Precancerosas/cirugíaAsunto(s)
Carcinoma de Células Escamosas/virología , Infecciones por Papillomavirus/complicaciones , Neoplasias del Pene/virología , Neoplasias Cutáneas/virología , Biopsia , Enfermedad de Bowen/virología , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Crioterapia/métodos , Diagnóstico Diferencial , Electrocoagulación/métodos , Humanos , Masculino , Neoplasias del Pene/patología , Neoplasias del Pene/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Resultado del TratamientoRESUMEN
Squamous cell carcinomas of the oral cavity and lips consistently have a high incidence (they constitute the fifth most common form of cancer in France) and carry a heavy prognosis, particularly if diagnosed late. According to different studies, between 10 and 80% of such carcinomas occur in a pre-existing or precancerous lesion. The World Health Organisation (WHO) recommends the use of two terms for such lesions: precursor lesions, i.e. histological lesions associated with intraepithelial neoplasia (IEN) and verrucous hyperplasia (VH), frequently resulting clinically in leukoplakia or erythroplakia; "at risk" lesions, which include lichen planus, submucosal oral fibrosis and certain forms of genodermatosis.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Neoplasias de los Labios/diagnóstico , Neoplasias de los Labios/patología , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/patología , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patología , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/epidemiología , Carcinoma in Situ/patología , Carcinoma in Situ/terapia , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/terapia , Carcinoma Verrugoso/diagnóstico , Carcinoma Verrugoso/epidemiología , Carcinoma Verrugoso/patología , Carcinoma Verrugoso/terapia , Estudios Transversales , Diagnóstico Tardío , Eritroplasia/diagnóstico , Eritroplasia/epidemiología , Eritroplasia/patología , Eritroplasia/terapia , Humanos , Leucoplasia Bucal/diagnóstico , Leucoplasia Bucal/epidemiología , Leucoplasia Bucal/patología , Leucoplasia Bucal/terapia , Labio/patología , Neoplasias de los Labios/epidemiología , Neoplasias de los Labios/terapia , Mucosa Bucal/patología , Neoplasias de la Boca/epidemiología , Neoplasias de la Boca/terapia , Lesiones Precancerosas/epidemiología , Lesiones Precancerosas/terapia , Pronóstico , Factores de RiesgoAsunto(s)
Tumor de Buschke-Lowenstein/patología , Neoplasias de los Genitales Masculinos/patología , Tumor de Buschke-Lowenstein/diagnóstico , Tumor de Buschke-Lowenstein/cirugía , Dióxido de Carbono , Neoplasias de los Genitales Masculinos/diagnóstico , Neoplasias de los Genitales Masculinos/cirugía , Infecciones por VIH/complicaciones , Humanos , Huésped Inmunocomprometido , Terapia por Láser , Masculino , PronósticoAsunto(s)
Liquen Escleroso y Atrófico/patología , Enfermedades del Pene/patología , Carcinoma de Células Escamosas/patología , Niño , Circuncisión Masculina , Diagnóstico Diferencial , Humanos , Liquen Escleroso y Atrófico/inmunología , Liquen Escleroso y Atrófico/terapia , Masculino , Enfermedades del Pene/inmunología , Enfermedades del Pene/terapia , Neoplasias del Pene/patología , Pene/patología , Lesiones Precancerosas/patología , RecurrenciaAsunto(s)
Enfermedades de los Genitales Masculinos/diagnóstico , Liquen Plano/diagnóstico , Clobetasol/uso terapéutico , Diagnóstico Diferencial , Enfermedades de los Genitales Masculinos/complicaciones , Enfermedades de los Genitales Masculinos/tratamiento farmacológico , Glucocorticoides/uso terapéutico , Hepatitis C Crónica/complicaciones , Humanos , Liquen Plano/complicaciones , Liquen Plano/tratamiento farmacológico , MasculinoAsunto(s)
Linfangitis/diagnóstico , Enfermedades del Pene/diagnóstico , Pene/patología , Humanos , Masculino , EsclerosisRESUMEN
BACKGROUND: Keloids are benign fibro-proliferative skin lesions that very rarely occur on the soles. Because of their rarity, the diagnosis of plantar keloids can be difficult. We describe the clinical and histopathological characteristics of eight plantar keloids. METHODS: All patients presenting with plantar keloids between 2005 and 2012 in our Dermatology unit were retrospectively included. Diagnosis was definitely established by re-reading of pathological slides in all cases. Clinical characteristics, histopathological features, treatments given and their results were collected. RESULTS: Six patients were included. Five patients had a single plantar keloid and one had three lesions. They all were of African descent. Only one patient remembered of a previous injury at the site of the keloid. Three patients presented with associated extra-plantar keloids. In four patients, the diagnosis of keloid was not initially suspected clinically or histologically. Re-reading of the clinical photographs showed that the eight plantar keloids shared common morphological features, leading to a distinctive clinical picture, defined by a hardened lesion of rounded or polycyclic shape, with a pink surface crossed by keratotic furrows and the presence of a hyperkeratotic rim. Concerning pathological features, typical hyalinized collagen can be missing and deep fibrosis should not rule out the diagnosis of keloid. Intralesional injection of triamcinolone acetonide and orthopaedic shoes were useful. All patients who had surgical excision presented recurrence. CONCLUSION: The knowledge of the clinical features of plantar keloids is helpful to the diagnosis. There is no well-established treatment, but supportive measures are important.
Asunto(s)
Aminoquinolinas/administración & dosificación , Colchicina/administración & dosificación , Procedimientos Quirúrgicos Dermatologicos/métodos , Dermatosis del Pie/diagnóstico , Queloide/diagnóstico , Triamcinolona/administración & dosificación , Adyuvantes Inmunológicos/administración & dosificación , Adulto , Biopsia , Vías de Administración de Medicamentos , Femenino , Estudios de Seguimiento , Dermatosis del Pie/terapia , Ortesis del Pié , Glucocorticoides/administración & dosificación , Supresores de la Gota/administración & dosificación , Humanos , Imiquimod , Queloide/terapia , Queratolíticos/administración & dosificación , Imagen por Resonancia Magnética , Masculino , Recurrencia , Estudios Retrospectivos , Resultado del TratamientoAsunto(s)
Enfermedades de los Genitales Masculinos , Psoriasis , Corticoesteroides/uso terapéutico , Antiinflamatorios/uso terapéutico , Artritis Psoriásica/epidemiología , Circuncisión Masculina , Comorbilidad , Diagnóstico Diferencial , Enfermedades de los Genitales Masculinos/diagnóstico , Enfermedades de los Genitales Masculinos/tratamiento farmacológico , Enfermedades de los Genitales Masculinos/epidemiología , Enfermedades de los Genitales Masculinos/patología , Enfermedades de los Genitales Masculinos/psicología , Humanos , Inmunosupresores/uso terapéutico , Masculino , Enfermedades de la Uña/epidemiología , Psoriasis/diagnóstico , Psoriasis/tratamiento farmacológico , Psoriasis/epidemiología , Psoriasis/patología , Psoriasis/psicología , Calidad de Vida , Dermatosis del Cuero Cabelludo/epidemiologíaAsunto(s)
Dolor Crónico/diagnóstico , Dolor Crónico/terapia , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/terapia , Analgésicos/uso terapéutico , Dolor Crónico/etiología , Diagnóstico Diferencial , Humanos , Masculino , Dolor Referido/diagnóstico , Dolor Referido/etiología , Enfermedades del Pene/etiologíaAsunto(s)
Carcinoma de Células Escamosas/prevención & control , Circuncisión Masculina , Enfermedades del Pene/prevención & control , Neoplasias del Pene/prevención & control , Enfermedades de Transmisión Sexual/prevención & control , Adulto , Balanitis/epidemiología , Balanitis/prevención & control , Carcinoma in Situ/epidemiología , Carcinoma in Situ/prevención & control , Carcinoma de Células Escamosas/epidemiología , Niño , Preescolar , Circuncisión Masculina/efectos adversos , Circuncisión Masculina/psicología , Circuncisión Masculina/estadística & datos numéricos , Cultura , Humanos , Recién Nacido , Liquen Escleroso y Atrófico/epidemiología , Liquen Escleroso y Atrófico/prevención & control , Masculino , Enfermedades del Pene/epidemiología , Neoplasias del Pene/epidemiología , Fimosis/cirugía , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Prospectivos , Religión , Enfermedades de Transmisión Sexual/epidemiologíaAsunto(s)
Antineoplásicos/administración & dosificación , Indoles/administración & dosificación , Recurrencia Local de Neoplasia/tratamiento farmacológico , Pirroles/administración & dosificación , Sarcoma/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Adulto , Amputación Quirúrgica , Muñones de Amputación , Axila , Esquema de Medicación , Antebrazo , Mano , Humanos , Masculino , Neoplasias de los Músculos/tratamiento farmacológico , Neoplasias de los Músculos/secundario , Sarcoma/secundario , Sarcoma/cirugía , Neoplasias Cutáneas/secundario , Neoplasias Cutáneas/cirugía , Sunitinib , Resultado del Tratamiento , OmbligoRESUMEN
BACKGROUND: Penile biopsy can be useful to establish an accurate diagnosis when managing male genital dermatoses. We investigated the value of genital biopsy by comparing suspected clinical diagnosis with final histologic diagnosis. PATIENTS AND METHOD: We retrospectively examined the clinical file of men with genital dermatoses undergoing genital biopsy. We collected details of age, biopsy site, suspected diagnosis after clinical examination and histologic diagnosis. RESULTS: One hundred and thirty-eight male patients were enrolled in the study. Their mean age was 52 years. Most biopsies (41%) were performed on the glans. Microscopic examination failed to rule out a diagnosis in 14.5% of the cases. It confirmed the clinically suspected diagnosis in 29.7% of cases and ruled out a particular diagnosis from among several clinical hypotheses in 26.8% of cases. The histological diagnosis had not been suspected in 18.1% of cases. DISCUSSION: Penile biopsy has an important role in the diagnosis of penile dermatoses. In our study, in 44.9% of cases, a clinically unsuspected diagnosis was identified or a differential diagnosis was resolved.
Asunto(s)
Enfermedades de la Piel/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Humanos , Masculino , Persona de Mediana Edad , Pene/patología , Estudios Retrospectivos , Adulto JovenAsunto(s)
Dolor Crónico/etiología , Circuncisión Masculina/efectos adversos , Neuralgia/etiología , Pene , Adulto , Humanos , MasculinoRESUMEN
BACKGROUND: Extra-mammary Paget's disease (EMPD) is currently considered a slowly progressing in situ adenocarcinoma. It is much more rarely associated with an invasive underlying adenocarcinoma than in mammary sites, where this association is almost always seen. However, an invasive course is to be feared where EMPD has been progressing for several years. PATIENTS AND METHODS: A 59-year-old man consulted for treatment of scrotal Paget's disease present for over 15 years and treated with topical emollients alone. Two infiltrated areas had recently appeared and their excision led to a diagnosis of invasive Paget's disease at these two points. Metastasis occurred 10 months later and rapidly proved fatal. DISCUSSION: Until now, non-invasive EMPD has been considered a fairly non-aggressive disease due to its indolent progression. However, it is characterised by considerable risk of relapse following surgical excision, regardless of the surgical margin. Despite a good prognosis at the intraepithelial stage, the rising life expectancy of the population means a greater likelihood of an invasive course or of the appearance of an underlying adenocarcinoma, and management of this condition can thus no longer be neglected. The present clinical case underscores the need for closer surveillance of the disease as of the intraepithelial stage.
Asunto(s)
Neoplasias de los Genitales Masculinos , Enfermedad de Paget Extramamaria , Escroto , Resultado Fatal , Neoplasias de los Genitales Masculinos/patología , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Paget Extramamaria/secundarioRESUMEN
BACKGROUND: The treatment of stage I Merkel cell carcinoma (MCC) usually includes wide local excision (WLE) combined with irradiation of the tumor bed (ITB). No randomized study has ever been conducted in MCC. The purpose of this study was to assess the efficacy and safety of prophylactic adjuvant radiotherapy on the regional nodes. PATIENTS AND METHODS: In this randomized open controlled study, patients for a stage I MCC treated by WLE and ITB were randomly assigned to regional adjuvant radiotherapy versus observation. Overall survival (OS) and probability of regional recurrence (PRR) were primary end points. Progression-free survival (PFS) and tolerance of irradiation were secondary end points. RESULTS: Eighty-three patients were included before premature interruption of the trial, due to a drop in the recruitment mainly due to the introduction of the sentinel node dissection in the management of MCC. No significant improvement in OS (P = 0.989) or PFS (P = 0.4) could be demonstrated after regional irradiation, which, however, significantly reduced the PRR (P = 0.007) with 16.7% regional recurrence rate in the observation arm versus 0% in the treatment arm. The treatment was well tolerated. CONCLUSION: The adjuvant regional irradiation significantly decreased the PRR in MCC, but benefit in survival could not be demonstrated.