Erythroplasia of Queyrat (Bowen Disease of the Glans Penis)

Updated: Nov 07, 2019
  • Author: Vikas Shrivastava, MD; Chief Editor: Dirk M Elston, MD  more...
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Overview

Background

Erythroplasia of Queyrat (EQ) is an in situ squamous cell carcinoma of the penis. [1] The glans and prepuce are most commonly involved. [2] Erythroplasia of Queyrat is seen almost exclusively in uncircumcised men. Progression to invasive carcinoma may occur, and spontaneous regression is unlikely. [3, 4]

Erythroplasia of Queyrat was originally described by Tarnovsky in 1891 and later appreciated as a penile disease by Fournier and Darier in 1893. Studies by Queyrat in 1911 allowed erythroplasia of Queyrat to be accepted as a distinct entity. In 1933, Sulzberger and Satenstein recognized erythroplasia of Queyrat as a form of carcinoma in situ. [5]

Some references equate erythroplasia of Queyrat with the term Bowen disease of the glans penis”. [6] The term erythroplasia of Queyrat is used for squamous cell carcinoma in situ (SCCIS) of the mucocutaneous epithelium of the penis. [1]

Some references extend use of the term erythroplasia of Queyrat to also describe SCCIS of the labia minora, vestibule, vulva, labia majora, conjunctivae, buccal mucosa, and anal mucosa. [1, 4, 7]

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Etiology

The etiology of erythroplasia of Queyrat remains unclear. The following have been proposed to contribute to the development and progression of erythroplasia of Queyrat [1, 4, 6, 8, 9, 10, 11] :

  • Lack of circumcision

  • Chronic irritation, inflammation, or infection: Includes urine, smegma, trauma, herpes simplex viral infection, bacteria, heat, friction, trauma

  • Zoon balanitis

  • Human papillomavirus infection (HPV) types 8 and 16: In 2010, however, Nasca et al failed to detect HPV in lesions of 11 patients with erythroplasia of Queyrat

  • Immunosuppression (including HIV infection)

  • UV light

  • Phimosis

  • Multiple sexual partners

  • Smoking

  • Chronic underlying diseases (lichen sclerosis, lichen planus)

  • Social/cultural habits, hygiene, religious practices

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Epidemiology

Frequency

Erythroplasia of Queyrat is a rarely reported disorder. It makes up less than 1% of malignancies in males. [6]

Age

Erythroplasia of Queyrat is a disease of middle-aged to elderly males. [8] It has been described in males ranging from age 20-80 years. [12]

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Prognosis

The cure rate for erythroplasia of Queyrat is high if lesions are identified and treated early.

If urethral involvement is noted, treatment may be both more challenging and lead to higher recurrence rates. [6]

Transformation to invasive carcinoma is possible within erythroplasia of Queyrat lesions. Graham and Helwig reported 10% of erythroplasia of Queyrat cases progressing to malignant disease. [12] Others report progression rates as high as 33%. [4] Cases of erythroplasia of Queyrat metastatic to local lymph nodes have also been reported. [13]

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