The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature

Kravvas, Georgios; Ge, Ludi; Ng, Jeremy; Shim, Tang Ngee; Doiron, Philip; Watchorn, Richard; Kentley, Jonathan; Panou, Evdoxia; Dinneen, M; Freeman, Alex; Jameson, Charles; Haider, Aiman; Francis, Nicholas; Minhas, Suks; Alnajjar, Hussain M.; Muneer, Asıf; Bunker, C.B.

doi:10.1080/09546634.2020.1800574

Cited by 35 publications

(53 citation statements)

References 114 publications

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“…The main differential diagnoses are penile Bowen’s disease (red plaques affecting the penis shaft) and erythroplasia of Queyrat (dark red, glistening, velvety, non-tender, eroded plaques on the glans penis and inner part of the prepuce), two clinical types of penile intraepithelial neoplasia induced by high risk human papillomaviruses (HPVs) (eg HPV16) 6. Erythroplasia of Queyrat can coexist with plasma cell balanitis 78…”

Section: Answermentioning

confidence: 99%

A recurrent rash on the penis

Kreuter

Koushk‐Jalali

2021

BMJ

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Section: Answermentioning

confidence: 99%

A recurrent rash on the penis

Kreuter

Koushk‐Jalali

2021

BMJ

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“…4,5 However, it may also play a prophylactic and therapeutic role in a significant amount of noninfectious dermatoses that almost exclusively affect uncircumcised men. 3,6,7 A "dysfunctional foreskin" is associated with male genital lichen sclerosus (MGLSc), balanoposthitis, Zoon's balanitis (ZB), non-HPV-related penile intraepithelial neoplasia (PeIN), and invasive squamous cell carcinoma (iSCC), among others. In fact, the most important risk factor for PeIN and iSCC is the uncircumcised state.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, the most important risk factor for PeIN and iSCC is the uncircumcised state. 7 Neonatal circumcision is not routinely practiced in South America, where the estimated prevalence ranges from 0.11% to 4.2% (with 0.62% in Uruguay). 8 Although it is logical to assume that male genital dermatoses are more prevalent in Hispanic men, there have been no studies focused on this demographic to date.…”

Section: Introductionmentioning

confidence: 99%

Creation of a pioneering interdisciplinary genital dermatology unit for Hispanic men: First 269 patients

et al. 2021

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The role of circumcision in partially protecting against sexually transmitted infections (STIs) and other dermatoses has been documented. Neonatal circumcision is not routinely practiced in South America. Although it is logical to assume that male genital dermatoses are more prevalent in Hispanic men, they are underrepresented in the existing literature. Objective: To describe the epidemiological characteristics from our male genital dermatology unit in Montevideo (Uruguay), the diagnoses, and correlate them with circumcision status and comorbidities. Methods: A retrospective observational cohort study was conducted. A dermatologist and urologist evaluated all patients using standard questionnaires. In 3 years and 8 months, 269 patients were seen. Median age was 41, prevalence of neonatal circumcision was 0.7%, HIV was 4.2%, STIs were 24.9%, non-STIs were 63.9%, and both (STI + non-STI) were 11.2%. Most frequent entities: eczema/balanoposthitis (27.1%), condyloma (24.9%), and lichen sclerosus (15.6%). Data correlating circumcision and other diagnoses did not reach statistical significance. HIV was positively associated with other STIs ( p < 0.05), and an association with balanoposthitis was seen; however, it did not reach statistical significance ( p < 0.1). Main limitation was small sample size. This is the first study of its kind based on Hispanic patients. Collaboration between specialties proved to be fundamental. Further studies are needed in this demographic to find an association between circumcision, comorbidities, and genital dermatoses.

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“…Also, the differentiated, lichen-sclerosus subtype, can be a very challenging diagnosis even for an experienced pathologist. 2 The diagnosis of PeIN is certainly not going to be achieved if it is not included in the clinical differential diagnosis in the first place and if histology is not subsequently routinely undertaken except for ‘suspicious’ lesions. In approximately 45% of our 345 patients with PeIN, the diagnosis was not made clinically and in ~8% a confident clinical diagnosis (warts, psoriasis, lichen sclerosus, lichen planus or cancer) was made prior to biopsy or circumcision.…”

mentioning

confidence: 99%

“…In approximately 45% of our 345 patients with PeIN, the diagnosis was not made clinically and in ~8% a confident clinical diagnosis (warts, psoriasis, lichen sclerosus, lichen planus or cancer) was made prior to biopsy or circumcision. 2…”

mentioning

confidence: 99%