Presentation
AB - We are presenting the morphological features of 121 cases of atypical penile intraepithelial lesions. [jhu.pure.elsevier.com]
[…] in the middle and lower third of the epithelium If penile carcinoma is present, is usually warty, basaloid or warty basaloid variant Microscopic (histologic) images Images hosted on PathOut server: Contributed by Alcides Chaux, M.D. and Antonio Cubilla [pathologyoutlines.com]
Aims We describe the clinical presentation, diagnostic process and management of PIN cases presenting to the sexual health clinic. Results Five cases were identified from August 2010 to March 2011. [sti.bmj.com]
OBJECTIVES To describe the presentation and treatment of patients with PIN. METHODS Thirty-five patients presenting with PIN over a 7-year period are described. [wwww.unboundmedicine.com]
List of publications » Penile intraepithelial neoplasia: histopathological evaluation, HPV typing, clinical presentation and treatment A1 Journal article – refereed Penile intraepithelial neoplasia: histopathological evaluation, HPV typing, clinical presentation [research.utu.fi]
Entire Body System
- Inflammation
Dense lymphocytic inflammation, dermal melanophages, and few scattered suprabasal dendritic melanocytes were seen in the heavily pigmented portion of the lesion (Fig 3). [docksci.com]
The underlying stroma shows chronic inflammation and vascular proliferation. By immunohistochemistry, p16 is diffusely positive. Ki-67 proliferative index is increased at over 80% in the epithelial component. [acupath.com]
Published online: 09 Dec 2002 Favourite Read & Respond Original articles Tea tree oil reduces histamine‐induced skin inflammation Authors: K.J. Koh, A.L. Pearce, G. Marshman, et al. Published online: 09 Dec 2002 Favourite Read & Respond [bjdonline.com]
The following signs and symptoms may occur: Redness and inflammation Itching Crusting or scaling Pain Ulcers Bleeding In the late stages, discharge from the penis, difficulty pulling back foreskin or difficulty passing urine Images of penile intraepithelial [dermnetnz.org]
Take Quiz AAD Guidelines: Prevention of AD flares Take Quiz Stages of eczematous inflammation Take Quiz AAD Guidelines: AD and allergic disease Take Quiz Inside hand eczema Take Quiz Guidelines: Inside AD Take Quiz Guidelines for the topical treatment [mdedge.com]
- Falling
Falling incidence of penis cancer in an uncircumcised population (Denmark 1943–90). BMJ. 1995;311:1471 3. Porter WM, Francis N, Hawkins D, Dinneen M, Bunker CB. Penile intraepithelial neoplasia: clinical spectrum and treatment of 35 cases. [journals.lww.com]
- Chronic Infection
Penile intraepithelial neoplasia is associated with: Chronic infection with human papillomavirus (HPV), the cause of genital warts. HPV-16 is the most common type identified. [dermnetnz.org]
Predisposing factors include lack of circumcision, poor hygiene, and chronic infection. [emedicine.medscape.com]
Premalignant penile lesions can be broadly divided into those related to HPV infection, and those which are not HPV related but caused by chronic inflammation. [ncbi.nlm.nih.gov]
[…] oncoproteins to combine with p53, allowing the virus to overcome this regulatory mechanism. 27 This process alone has not proved sufficient to cause neoplasia, but the degradation process may be augmented by other factors, such as altered host immune status, chronic [jaoa.org]
- Candidiasis
The diagnosis is often delayed, because penile intraepithelial neoplasia may resemble other conditions such as balanitis, candidiasis, dermatitis and psoriasis. [dermnetnz.org]
Skin
- Papule
Condylomata acuminata, papules, and macules were observed in 309 of the 480 men (64.4 percent). In 204 of them (42.5 percent), macules or slightly elevated papules were detected only after application of acetic acid. [cirp.org]
Characteristic findings on physical examination Presents as well circumscribed, solitary or multiple, small, pigmented papules with a flat-to-verrucous surface ( Figure 1 ). Papules may coalesce into larger plaques. [dermatologyadvisor.com]
Methods: Ninety-two patients who presented with lesions suggesting intraepithelial neoplasia (pigmented or leukoplastic papules, keratinized condylomata, or erythroplastic macules) underwent biopsy, for histologic and virologic studies. [eurekamag.com]
The morphological features of PeIN can be classified as flat lesions, leukoplakic lesions, pigmented papules, or a mixture of the three 9. The noninvasive nature of PeIN allows for curative penile-preserving therapy. [journals.lww.com]
- Erythema
These changes were observed on a background of erythema (Fig 1). Fig 1. Penile intraepithelial neoplasia. Clinical photo demonstrating erosion, irregular hyperpigmentation, and erythema on the dorsal prepuce. [docksci.com]
[…] associated with invasive carcinoma is more prevalent in regions with a high incidence of penile cancer Common in HIV+ men with anal dysplasia ( J Invest Dermatol 2008;128:2316 ) Clinical features Whitish areas in glans, coronal sulcus or inner foreskin Erythema [pathologyoutlines.com]
Mild burning sensation and erythema at the site of application were the only adverse effects observed in this case series, with rapid clinical clearing of disease. [dermatologyadvisor.com]
Take Quiz Sunburn and solar erythema Take Quiz Rare types of melanoma Take Quiz Prevention and detection of melanoma on the back Take Quiz CDC report: Melanoma incidence Take Quiz Incidence of BCC Take Quiz Health concerns associated with sunscreen use [mdedge.com]
- Skin Disease
Penile intraepithelial neoplasia is a rare pre-cancerous disease of the outer skin layer ( epidermis ) of the penis. [dermnetnz.org]
[…] and coinfection Take Quiz Regional tick-borne diseases Take Quiz Genital skin cancer lesions & organ transplant recipients, Pt 1 Take Quiz Lyme disease testing and management Take Quiz Lyme disease: Clinical findings Take Quiz Diagnosis & management [mdedge.com]
Penile carcinogenesis in a low-incidence area: a clinicopathologic and molecular analysis of 115 invasive carcinomas with special emphasis on chronic inflammatory skin diseases. Am J Surg Pathol. 2011;35(7):998-1006. Stern RS, Bagheri S, Nichols K. [cancercentrum.se]
- Dermatitis
[…] of disease Take Quiz Atopic dermatitis: Association with smoking Take Quiz Understanding chronic eczematous inflammation Take Quiz Clinical manifestations of atopic dermatitis Take Quiz Epidemiology & etiology of atopic dermatitis Take Quiz Types of [mdedge.com]
The diagnosis is often delayed, because penile intraepithelial neoplasia may resemble other conditions such as balanitis, candidiasis, dermatitis and psoriasis. [dermnetnz.org]
Psychiatrical
- Suggestibility
The absence of viral DNA from uninvolved skin suggests that this coinfection is more than coincidental and may involve synergy between these viruses, as has already been suggested for HPV and herpes simplex 2 virus. [ncbi.nlm.nih.gov]
The mean age of patients with Grade III PIN was 7 years older then the mean age of patients with Grade I PIN, which suggests a step progression similar to that of cervical intraepithelial neoplasia. [eurekamag.com]
You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. share alike – If you alter, transform, or build upon this work, you may distribute the resulting work only under the same or similar license [commons.wikimedia.org]
Recent evidence from Europe suggests that the incidence of penile cancer and its precursor lesion (penile intraepithelial neoplasia [PeIN]) may be on the rise. [cancerres.aacrjournals.org]
Neurologic
- Irritability
Although irritation, burning sensation, fissuring or maceration may be associated, PKMB is generally asymptomatic. [ijstd.org]
Chronic skin disease, especially lichen sclerosus and lichen planus Smoking Immune suppression by medications or disease Chronic irritation by urine, friction or injury to the penile area. [dermnetnz.org]
Risk factors The following risk factors may increase a man’s chance of developing PeIN: HPV infection inability to fully pull back (retract) the foreskin over the glans (called phimosis) poor genital hygiene long-term (chronic)irritation, inflammation [cancer.ca]
The most common adverse effect is local skin irritation at the application site. Other adverse effects include headache, flu like symptoms and myalgia. [tau.amegroups.com]
Urogenital
- Penile Lesion
This review focuses on premalignant penile lesions and the associations of these lesions with the development of invasive penile cancer. Read this article (multiple options) Comments Related Papers [readbyqxmd.com]
Exposing the penile surface to ultraviolet rays causes penile tumors. Signs and symptoms HPV penile lesions occur in the form of lobules with an irregular surface that appears on the perineum and perianal areas. [news-medical.net]
Histologically: all biopsies had evidence of HPV infection, 4/5 had PIN3 and 1 had PIN1. 2/5 also had anal intraepithelial neoplasia; 1 presented to the surgeons with an anal lesion, but his penile lesion was missed. [sti.bmj.com]
A 32-year-old heterosexual man with acquired immunodeficiency syndrome (AIDS) who had penile lesions of KS with overlying epithelial changes characteristic of intraepithelial neoplasia associated with concurrent infection by human papillomavirus (HPV) [ncbi.nlm.nih.gov]
- Genital Lesions
This increased incidence of genital lesions requires a review of the clinicopathological classification of penile intraepithelial neoplasia (PIN) to help the clinician differentiate the aetiology in order to propose the least mutilating treatment. [ncbi.nlm.nih.gov]
HPV type16 predominates and in one study represented 79% of all high-risk human papillomavirus infections. [4] In a biopsy cohort of 2754 men with external genital lesions, condyloma primarily contained HPV 6 or 11; penile intraepithelial neoplasia lesions [emedicine.medscape.com]
Only 3 of the 25 men (12%) were aware of any genital lesions, but peniscopy after acetic acid washes revealed clinical lesions suggestive of HPV lesions in 20 men (80%). [jaoa.org]
Workup
Microbiology
- Human Papillomavirus
Br J Cancer 2002;86:705-711 Gross G, Barrasso R: Human Papillomavirus Infection. [karger.com]
American Journal of Surgical Pathology 34(3): 385-392, 2010 Penile intraepithelial neoplasia: clinical presentation and an analysis of the physical state of human papillomavirus DNA. [eurekamag.com]
The aim of this study was to test the usefulness of immunohistochemical p16INK4a overexpression, considered as a surrogate for high-risk human papillomavirus infection, using this classification system. [insights.ovid.com]
Human papillomavirus DNA detection in male sexual partners of women with genital human papillomavirus infection. Urology. 2005; 65 (2):251-255. 62 Bleeker MCG, Hogewoning CJA, Berkhof J, et al. [jaoa.org]
RESULTS Our observations include: (i) patients with BP are younger than those with EQ or BD and sometimes have a history of immunosuppression; (ii) patients with BP usually have a history or clinical evidence of previous genital human papillomavirus infection [wwww.unboundmedicine.com]
Treatment
The total recurrence rate in our cohort was 13.8%, but if the treatment was divided into surgical and topical treatment, the recurrence rates would be 57% for topical treatment and 3.4% for surgical excision. [journals.lww.com]
Prognosis
Exact prognosis of PEIN unknown as most studies were retrospective. advertisement advertisement [auanet.org]
In addition to the extent of tumor invasion and lymph node status, histologic type plays a role in prognosis. Worse prognosis is associated with basaloid and sarcomatoid subtypes. [emedicine.medscape.com]
Encyclopedia) Hyperthermia for treating cancer (Medical Encyclopedia) Laser therapy for cancer (Medical Encyclopedia) Photodynamic therapy for cancer (Medical Encyclopedia) Targeted therapies for cancer (Medical Encyclopedia) Understanding your cancer prognosis [icdlist.com]
In this study we are also demonstrating this cell to be an indicator of adverse prognosis as compared with the maturing keratining typical squamous cell. [appliedcr.biomedcentral.com]
Take Quiz Treating herpes zoster in immunocompromised patients Take Quiz Syphilis: Diagnosis & staging Take Quiz Acute hemorrhagic edema of infancy: Confirming diagnosis Take Quiz Zika: Cutaneous signs & symptoms Take Quiz Actinomycetoma: Treatment & prognosis [mdedge.com]
Etiology
Rosacea and depression Take Quiz Rosacea risk and smoking Take Quiz Managing rosacea: Erythematolotelangiectatic & papulopustular types Take Quiz Managing rosacea: Ocular & phymatous types Take Quiz Clinical findings & treatment of rosacea Take Quiz Etiology [mdedge.com]
Giuliano DOI: 10.1158/1538-7445.AM2013-4848 Published April 2013 Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC Abstract The human papillomavirus (HPV) is an established etiologic agent in 50% of penile cancers. [cancerres.aacrjournals.org]
Karger AG, Basel References Dillner J, von Krogh G, Horenblas S, Meijer CJ: Etiology of squamous cell carcinoma of the penis. [karger.com]
The theory that penile and cervical cancer may have a common etiology was proposed as early as 35 years ago. [jaoa.org]
The lesion is an intraepithelial or in situ neoplasm; the associated risk for progression to invasive carcinoma has been documented as up to 33%. [7] The specific etiologic factors remain unclear. [emedicine.medscape.com]
Epidemiology
These conditions are distinct clinical entities and have different epidemiological and aetiological associations and prognostic implications. OBJECTIVES To describe the presentation and treatment of patients with PIN. [wwww.unboundmedicine.com]
Epidemiology, Hui-Yi Lin, William Fulp, Martha Abrahamsen, Beibei Lu, Luisa L. Villa, Eduardo Lazcano-Ponce and Anna R. [cancerres.aacrjournals.org]
These conditions are distinct clinical entities and have different epidemiological and aetiological associations and prognostic implications. Objectives To describe the presentation and treatment of patients with PIN. [bjdonline.com]
Take Quiz Treatment of actinic keratosis Take Quiz Actinic keratosis: Epidemiology & etiology Take Quiz Quiz Recognizing seborrheic keratosis Take Quiz Seborrheic keratosis: Systemic implications & complications Take Quiz Quiz JAAD Guidelines: Acne fulminans [mdedge.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]
Pathophysiology
Pathophysiology Bowen disease is a clinical presentation of in situ squamous cell carcinoma that involves the shaft of the penis. [emedicine.medscape.com]
Disease burden & QOL in psoriasis patients Take Quiz Psoriasis & risk of depression Take Quiz Understanding patient-reported experiences of living with psoriasis Take Quiz Psoriasis treatment: Part 2 Take Quiz Systemic therapies for psoriasis Take Quiz Pathophysiology [mdedge.com]
This acknowledges the role of HPV in the pathophysiology of these lesions ( 7 ). [tau.amegroups.com]
[…] abrasions and areas of inflammation tend to react by turning white. 19, 20 One investigation comparing specimens obtained by clinicians with those collected by the patients themselves found a greater yield of usable cells in self-collected specimens. 21 Pathophysiology [jaoa.org]
Prevention
Early detection and treatment of premalignant penile lesions may prevent malignant progression while avoiding penile amputation. [readbyqxmd.com]
Most importantly, the detection and treatment of these lesions participate in the prevention of cervical cancer. [ncbi.nlm.nih.gov]
Heidelberg, Springer, 2011; Minhas S, Manseck A, Watya S, Hegarty PK: Penile cancer - Prevention and premalignant conditions. Urology 2010;76:S24-S35 von Krogh G, Horenblas S: The management and prevention of premalignant penile lesions. [karger.com]
Take Quiz Sunburn and solar erythema Take Quiz Rare types of melanoma Take Quiz Prevention and detection of melanoma on the back Take Quiz CDC report: Melanoma incidence Take Quiz Incidence of BCC Take Quiz Health concerns associated with sunscreen use [mdedge.com]
[…] with HPV exposure to arsenic – this is a risk factor only for Bowen’s disease not being circumcised Although there is some evidence that circumcision reduces the risk of penile cancer, there is not enough evidence to recommend circumcision as a way of preventing [cancer.ca]