Modern aspects of the clinic, diagnosis and treatment of HPV-associated penile intraepithelial neoplasia

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A clinical case that demonstrates the development of human papilloma virus (HPV)-associated penile intraepithelial neoplasia (PIN), namely the erythematous form of bowenoid papulosis in a young patient, as well as a delay in making a correct diagnosis due to incorrect diagnostic tactics and low alertness of doctors regarding oncologic diseases, is presented in the article. Penile intraepithelial neoplasia is the histological term for precancerous lesions of the penis. Timeliness is important in the diagnosis of PIN, since currently there is a high morbidity and mortality associated with the progression to squamous cell penile carcinoma. From the morphologic and pathogenetic standpoints, HPV-negative (differentiated) and HPV-positive subtypes of PIN are divided. The latter includes Bowenoid papulosis, erythroplasia of Queyrat and Bowen's disease. It is important to carry out a differential diagnosis between these lesions, since the rate of development of penile cancer for erythroplasia of Queyrat is 30%, for Bowen's disease is 5% and for bowenoid papulosis is 1%.

作者简介

N. Chernova

Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology

编辑信件的主要联系方式.
Email: d.chernova@mail.ru
ORCID iD: 0000-0002-4111-6670

Ph.D., MD, Head of the Department of Anogenital Dermatosis and Sexually Transmitted Infections

俄罗斯联邦, Moscow

N. Frigo

Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology

Email: frigo.n@mosderm.ru
ORCID iD: 0000-0001-6231-971X

Ph.D., MD, Head of the Department of Scientific and Applied Research Methods

俄罗斯联邦, Moscow

T. Markosyan

State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency

Email: tigranich2006@yandex.ru
ORCID iD: 0000-0003-1464-5654

д.м.н., профессор кафедры восстановительной медицины, физиотерапии Медико-биологического университета инноваций и непрерывного образования 

俄罗斯联邦, Moscow

I. Zadorozhnaya

Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology

Email: d.zadorozhnayais@mail.ru
ORCID iD: 0000-0001-7291-3149

Ph.D., junior researcher of the Department of Anogenital Dermatosis and Sexually Transmitted Infections

俄罗斯联邦, Moscow

参考

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2. Fig. 1. Clinical picture of intraepithelial neoplasia of the penis head in a 38-year-old patient before treatment (primary examination): a - erythematous plaque with clear boundaries and papillomatous growths on the surface; b - round plaque with clear boundaries of bright red varnished color with an area of hyperkeratotic papillomatous growths.

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3. Fig. 2. Clinical picture of intraepithelial neoplasia of the penis head as a result of topical therapy for 8 weeks with 5% imiquimod cream combined with interferon-alpha solution of 500 thousand units; preservation of the hyperkeratosis focus (marked with an oval).

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4. Fig. 3. The same observation, 2 months after discontinuation of topical treatment. New lesions on the glans penis in the form of pink flat plaques

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5. Fig. 4. Morphologic picture of HPV-associated penile intraepithelial neoplasia: a - micro specimen with multilayer squamous epithelium with koilocytic atypia; b - diffuse expression of p16 protein throughout the entire thickness of multilayered squamous epithelium at IGC examination.

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6. Fig. 5. The same observation, 1.5 months after 1 session of photodynamic therapy (PDT). The lesions on the head of the penis have resolved

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