Treating erythroplasia of Queyrat with photodynamic therapy following circumcision and dermabrasion.

We describe a case of a patient with erythroplasia of Queyrat located on the whole glans and end of the prepuce that was successfully treated with three courses of photodynamic therapy after the completion of circumcision and dermabrasion. Skin lesions disappeared after receiving this combination of treatments and have not recurred during the past 6 months of follow-up.

A successful treatment with ALA-PDT: A case-report on erythroplasia of Queyrat misdiagnosed as urethritis.

Queyrat erythroplasia is an intraepidermal squamous cell carcinoma localized on the glans penis or the inner side of the foreskin. It accounts for about 10% of all penile malignancies and up to 33% cases may lead to invasive squamous cell carcinoma and the intraurethral erythroplasia of Queyrat is relatively rare. Treatment of Queyrat erythroplasia present a challenge especially if the proximal urethra is involved. Here, we report a case of intractable Queyrat erythroplasia involving the urethral meatus. This case suggested that 5-aminolaevulinic acid photodynamic therapy is effective and safe in the treatment of Queyrat erythroplasia, which provides a new choice for the patients with Queyrat erythroplasia with poor therapeutic effect.

Ingenol mebutate therapy in erythroplasia of Queyrat: a new approach.

BACKGROUND: Erythroplasia of Queyrat (EQ) is a rare squamous cell carcinoma in situ, usually occurring on the glans penis, the prepuce, or the urethral meatus. Therapy is mandatory because it can progress to invasive carcinoma in up to 30% of cases. Treatment options include 5-fluorouracil, curettage, cryotherapy, radiotherapy, laser, partial or total penectomy, and microsurgery, as also with imiquimod and photodynamic therapies. METHODS: Between 2015 to 2018 we treated five patients, with histologically confirmed EQ, with ingenol mebutate (IM) 0.015% gel applied for 3 days consecutively. RESULTS: Three patients showed complete response at one year follow up. Two patients showed partial response after two months, so they received a second course of therapy with IM. At one-year follow-up, one of them showed complete response, the other partial response. CONCLUSIONS: Our experience demonstrated that IM may be considered as an effective and safe treatment option in EQ. IM offers various advantages such as easy and fast application, rapid complete remission, better compliance, few side effects and excellent cosmetical results. The authors call for further exploitation in bigger trials.

Erythroplasia of Queyrat treated with methyl aminolevulinate-photodynamic therapy.

Erythroplasia of Queyrat (EQ) is a rare disease involving the mucosal and transitional surfaces of the penis. Effective treatment is necessary to minimize progression to squamous cell carcinoma. The standard therapy for EQ, partial or radical penectomy, is invasive; photodynamic therapy (PDT) may be an effective, non-surgical tissue-sparing option. We report the case of a 67-year-old patient with long-standing EQ who was suc-cessfully treated with methyl aminolevulinate-PDT (MAL-PDT). A complete clinical response, confirmedby incisional biopsy, was achieved af-ter fivesessions of every-other-week treatment. The patient experienced moderate edema, erythema and pain within 5-7 days after the treatment, without urination problems. Our experience and a review of the published literature suggest that MAL-PDT may represent a valuable treatment option for selected cases of histopathologically-confirmed EQ.

Erythroplasia of Queyrat treated with topical 5-fluorouracil

Abstract We report a 33-year-old male patient diagnosed with erythroplasia of Queyrat. The patient had an erythematous and eroded lesion affecting more than 50% of the glans associated with bleeding and local pain. Despite previous indication of penectomy, he was successfully treated with topical 5-fluorouracil.

Erythroplasia of Queyrat treated with topical 5-fluorouracil.

We report a 33-year-old male patient diagnosed with erythroplasia of Queyrat. The patient had an erythematous and eroded lesion affecting more than 50% of the glans associated with bleeding and local pain. Despite previous indication of penectomy, he was successfully treated with topical 5-fluorouracil.

Optical coherence tomography imaging of erythroplasia of Queyrat and treatment with imiquimod 5% cream: a case report.

Lesion biopsy is currently used to diagnose erythroplasia of Queyrat (EQ), a rare squamous cell carcinoma in situ of the glans penis, or to determine whether the cancer is invasive, although the results only apply to the area from which the biopsy is taken. In this case report, we illustrate for the first time the use of optical coherence tomography (OCT) in imaging the entire lesion in a patient with EQ. The results confirmed that the patient had in situ rather than invasive carcinoma. Consequently, non-invasive treatment with imiquimod 5%, a topical immunomodulator with antitumour and antiviral properties, was initiated. Excellent clinical results were observed 4 weeks after the patient had been treated with imiquimod 5% three times a week for 8 weeks, which were confirmed using OCT imaging. One year later, there was still no evidence of pathology either clinically or via OCT imaging. OCT imaging should be used in conjunction with biopsy evaluation in the diagnostic work-up of EQ. Imiquimod 5% is a suitable treatment for patients with EQ, and the treatment response can be evaluated using OCT.

Methyl-aminolevulinate photodynamic therapy for the treatment of erythroplasia of Queyrat in 23 patients.

Erythroplasia of Queyrat (EQ) is an intraepithelial squamous cell carcinoma localized on the mucosal or transitional surfaces. Standard therapy usually consists of the surgical removal of the cancer. The use of non-invasive alternative procedures, such as photodynamic therapy (PDT), has been considered for the treatment of EQ, although only a few reports regarding isolated cases or small series exist. We describe our cumulative experience with PDT, using topical methyl-aminolevulinate (MAL), for the management of 23 male patients with EQ of the glans penis and/or prepuce. Patients underwent two consecutive weekly MAL-PDT sessions, with the second session postponed in seven patients because of an excessive local reaction. Nineteen patients obtained a complete clinical remission without any sign of recurrence over an average post-treatment period of 18 months (range, 8-30 months). Cosmetic outcome was excellent in most patients, while dyschromic changes occurred in four cases. All patients experienced transient local adverse reactions and 22 of them reported severe or very severe symptoms during the session.

Methylaminolaevulinic acid photodynamic therapy in the treatment of erythroplasia of Queyrat.

BACKGROUND: Erythroplasia of Queyrat (EQ) is an intra-epithelial carcinoma of the penis. Progression to invasive carcinoma may occur. Its cause is unknown but some evidence suggests infection with human papillomavirus in the pathogenesis of EQ; however, recent data do not confirm this. Therapy is difficult and associated with important recurrence rates. Photodynamic therapy (PDT) employs a photosensitizer excited by visible light. The resulting photodynamic reaction selectively destroys atypical cells. Only few reports exist on the use of topical PDT in the treatment of EQ. OBJECTIVE: We report 11 cases of EQ treated by topical methylaminolaevulinic acid (MAL) PDT. RESULTS: Out of 11 male patients with EQ treated by topical MAL-PDT, 3 achieved complete remission sustained for 24 and 51 months and 4 a partial remission sustained for 2-45 months with a follow-up period of 4-45 months (1 patient lost to follow-up); surprisingly, 2 of the 4 patients with partial remission presented a complete remission after 20 and 45 months of follow-up, respectively, without further therapy. Four patients showed progression of the disease. CONCLUSION: Whereas topical MAL-PDT offers the advantages of tumour specificity, preservation of function and a good cosmetic result, side effects may cause treatment discontinuation in some cases. Treatment of EQ with PDT may represent a valuable option in selected cases, but our data do not allow considering it as a first-line therapeutic option.

Topical photodynamic therapy is very effective for oral verrucous hyperplasia and oral erythroleukoplakia.

BACKGROUND: Oral verrucous hyperplasia (OVH) and oral erythroleukoplakia (OEL) are two oral precancerous lesions with relatively high malignant transformation potential. One of the best cancer prevention strategies is to use a conservative and effective treatment modality to eliminate oral precancers to stop their further malignant transformation. Our previous studies have shown that the topical 5-aminolevulinic acid-mediated photodynamic therapy (topical ALA-PDT) using the 635-nm light-emitting diode (LED) light is very effective for OVH and OEL lesions. METHODS: Because the laser machine is a more-popular light source than the LED device in PDT clinics, in this study 40 OVH and 40 OEL lesions were treated once a week with the same PDT protocol but using the 635-nm laser light to evaluate whether this laser light-mediated topical ALA-PDT was also effective for OVH and OEL lesions. RESULTS: We found that all the 40 OVH lesions exhibited complete response (CR) after an average of 3.6 PDT treatments. Of the 40 OEL lesions, 38 showed CR after an average of 3.4 PDT treatments and two showed partial response (PR). Better PDT outcomes were significantly associated with OVH and OEL lesions with the smaller size, pink to red color, epithelial dysplasia, or thinner surface keratin layer. CONCLUSION: This study indicates that the laser light-mediated topical ALA-PDT is also very effective for OVH and OEL lesions. Therefore, we suggest that topical ALA-PDT using either the LED or laser light may serve as the first-line treatment of choice for OVH and OEL lesions.

Treatment of skin cancer and pre-cancer using topical ALA-PDT--a single hospital experience.

Our hospital (Shanghai Skin Diseases & STD Hospital) started to study 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) in 1996. So far, we have treated 76 cases of skin cancer and pre-cancer using topical ALA-PDT. They included squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Bowen's disease (BD), mammary and extramammary Paget disease, actinic keratosis (AK) and erythroplasia of Queyrat. In this overview article, we would like to present several representative cases and discuss our experience.

Erythroplasia of Queyrat treated with imiquimod 5% cream.

Imiquimod is an immune response-modifying agent with potent antiviral and antitumor activity effective in the treatment of various skin disorders, including in situ carcinoma of the skin (Bowen's disease). The case of a 64-year-old man affected by an in situ carcinoma of the glans mucosa, namely erythroplasia of Queyrat, successfully treated with imiquimod 5% cream is described. Because the results of tests for human papillomavirus infection were negative in this case, we suggest that imiquimod may have acted through an antitumor effect mediated by cytokine activation. This compound may represent an alternative treatment in patients with erythroplasia of Queyrat, although the dosing schedule and treatment duration require further evaluation.

Carcinoma espinocelular in situ tratado con imiquimod al 5 % / Spindle-cell carcinoma in situ treated with 5% imiquimod

Presentamos el caso de una mujer de 70 años sin antecedentes personales de interés que consultaba por presentar una placa de 9 cm de diámetro mayor en la región infraumbilical derecho con diagnóstico clínico e histológico de enfermedad de Bowen. Fue tratada con imiquimod al 5 % en crema, una vez al día, cuatro veces por semana, durante 8 semanas, con una excelente respuesta. Después de un año tras el tratamiento no han aparecido nuevas lesiones en la zona tratada

We present the case of a 70-year-old woman with no personal history of interest who presented to her physician with a plaque in the right infraumbilical region whose largest diameter measured nine centimeters. The clinical and histological diagnosis was Bowen's disease. She was treated with 5 % imiquimod cream, once a day, four times a week, for eight weeks, with an excellent response. One year after treatment, no new lesions have appeared in the treated area

Erythroplasia of Queyrat treated with topical methyl aminolevulinate photodynamic therapy.

An 82-year-old man presented with invasive squamous cell carcinoma of the glans penis arising in erythroplasia of Queyrat. He underwent Mohs' micrographic surgery for the invasive carcinoma. Seven weeks later, the residual erythroplasia of Queyrat was treated using photodynamic therapy. Methyl aminolevulinate cream was applied to the glans of the penis under occlusion for 3 hours and then, after local anaesthesia, irradiated with a 630-nm red-light-emitting diode lamp at a dose of 37 J/cm(2) for 8 min. The patient experienced some mild swelling, redness and pain, which subsided over the following 5 days. Eighteen weeks after photodynamic therapy, there had been no recurrence of the lesion, when the patient died from an unrelated cause.

Treatment of Bowen's disease and erythroplasia of Queyrat.

Bowen's disease of the skin may have differing clinical presentations depending on the skin surface on which it presents, but has the same histologic features of squamous cell carcinoma in situ wherever it occurs. The etiologic factors include ultraviolet light and human papillomavirus infection. The choice of therapy requires a consideration for retention of form, function and cosmosis while offering a high cure rate. The immunodualtory agent imiquimod has been shown to be an effective treatment on a variety of skin surfaces.

Imiquimod 5% cream in the treatment of human papillomavirus-16-positive erythroplasia of Queyrat.

Erythroplasia of Queyrat is a human-papillomavirus-associated carcinoma in situ of the penis. Imiquimod, a new topically applied immunomodulatory agent, has been successfully used in the treatment of anogenital warts. We report the complete clearance of HPV-16-positive erythroplasia of Queyrat with 5% imiquimod cream.