Erythroplasia of Queyrat (EQ) is a type of squamous cell carcinoma on the penis that affects the glans and prepuce.
It is found in uncircumcised men and can progress to invasive carcinoma. Tarnovsky first described EQ in 1891 and later it is recognized as penile disease in 1893.
Sulzberger and Satenstein identified it as carcinoma in situ in 1933. Erythroplasia of Queyrat refers to penile mucocutaneous epithelium squamous cell carcinoma in situ.
It is characterized due to their red and velvety appearance. Distinct clinical entity acknowledged for unique presentation and related risk factors.
Strong connection exists between emotional intelligence and high-risk HPV infections. People with weakened immune systems those with HIV at higher EQ risk.
Epidemiology
Uncommon EQ accounts for <1% male malignancies reported. It affects middle-aged to elderly males aged between 20 to 80 years old.
EQ is uncommon but more common in uncircumcised men also seen in women to affect the vulva region.
Anatomy
Pathophysiology
EQ stems from keratinocyte dysplastic changes with nuclear atypia and abnormal differentiation confined to epithelial layer.
HPV infection causes chronic inflammation, abnormal cell growth, and genetic instability. HPV-infected or dysplastic cells thrive due to immune system absence.
Patients with HIV or on immunosuppressive therapy at increased risk for cancer.
Dysplastic cells release pro-angiogenic factors to attract blood vessels for growth. Metabolic changes help dysplastic keratinocytes survive in harsh conditions.
Etiology
The causes of EQ are:
Lack of circumcision
Zoon balanitis
Immunosuppression
UV light
Phimosis
Multiple sexual partners
Genetics
Prognostic Factors
Early detection and treatment of EQ results in high cure rates but urethral involvement complicates treatment and increases recurrence.
Graham and Helwig found 10% of Queyrat lesions can transform into invasive carcinoma.
Generally good prognosis with treatment but monitor closely for potential malignant transformation risk.
Clinical History
Collect details including history of present illness, presenting symptom, and medical history to understand clinical history of patient.
Physical Examination
Skin and Mucosal Examination
Assessment of Lymph Nodes
Examination of Adjacent Structures
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Ulceration, bleeding, involvement of the urethra, dysuria or urinary discomfort, pain during intercourse
Differential Diagnoses
Balanoposthitis
Basal Cell Carcinoma
Cutaneous Squamous Cell Carcinoma
Irritant Contact Dermatitis
Lichen Planus
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
A photosensitizing agent is applied to the lesion to induce cytotoxic effects.
Surgical options are recommended for larger, recurrent, or poorly responsive lesions about invasive SCC.
Patients should be monitored every 3 to 6 months to detect recurrence and progression.
Use immunomodulator to stimulate the production of interferons and cytokines that increases immune response against the lesion.
Prognosis is good with treatment but must monitor for malignant transformation risk.
Procedural interventions are essential with excisional surgery and Mohs micrographic surgery provide definitive treatment, while laser ablation, cryotherapy, and photodynamic therapy indicated as less invasive options.
Erythroplasia of Queyrat (EQ) is a type of squamous cell carcinoma on the penis that affects the glans and prepuce.
It is found in uncircumcised men and can progress to invasive carcinoma. Tarnovsky first described EQ in 1891 and later it is recognized as penile disease in 1893.
Sulzberger and Satenstein identified it as carcinoma in situ in 1933. Erythroplasia of Queyrat refers to penile mucocutaneous epithelium squamous cell carcinoma in situ.
It is characterized due to their red and velvety appearance. Distinct clinical entity acknowledged for unique presentation and related risk factors.
Strong connection exists between emotional intelligence and high-risk HPV infections. People with weakened immune systems those with HIV at higher EQ risk.
Uncommon EQ accounts for <1% male malignancies reported. It affects middle-aged to elderly males aged between 20 to 80 years old.
EQ is uncommon but more common in uncircumcised men also seen in women to affect the vulva region.
EQ stems from keratinocyte dysplastic changes with nuclear atypia and abnormal differentiation confined to epithelial layer.
HPV infection causes chronic inflammation, abnormal cell growth, and genetic instability. HPV-infected or dysplastic cells thrive due to immune system absence.
Patients with HIV or on immunosuppressive therapy at increased risk for cancer.
Dysplastic cells release pro-angiogenic factors to attract blood vessels for growth. Metabolic changes help dysplastic keratinocytes survive in harsh conditions.
The causes of EQ are:
Lack of circumcision
Zoon balanitis
Immunosuppression
UV light
Phimosis
Multiple sexual partners
Early detection and treatment of EQ results in high cure rates but urethral involvement complicates treatment and increases recurrence.
Graham and Helwig found 10% of Queyrat lesions can transform into invasive carcinoma.
Generally good prognosis with treatment but monitor closely for potential malignant transformation risk.
Collect details including history of present illness, presenting symptom, and medical history to understand clinical history of patient.
Skin and Mucosal Examination
Assessment of Lymph Nodes
Examination of Adjacent Structures
Ulceration, bleeding, involvement of the urethra, dysuria or urinary discomfort, pain during intercourse
Balanoposthitis
Basal Cell Carcinoma
Cutaneous Squamous Cell Carcinoma
Irritant Contact Dermatitis
Lichen Planus
A photosensitizing agent is applied to the lesion to induce cytotoxic effects.
Surgical options are recommended for larger, recurrent, or poorly responsive lesions about invasive SCC.
Patients should be monitored every 3 to 6 months to detect recurrence and progression.
Use immunomodulator to stimulate the production of interferons and cytokines that increases immune response against the lesion.
Prognosis is good with treatment but must monitor for malignant transformation risk.
Dermatology, General
Genital area should be wash with mild, fragrance-free soap and water.
Ensure the genital region stays moisture-free to prevent fungal infections.
Use non-irritating personal care products and use cotton-based undergarments to reduce sweating and friction.
Avoid tight underwear or pants to reduce friction and irritation of the lesion.
Avoid intercourse until lesion healing is confirmed to prevent irritation and potential spread of infection.
Encourage the use of condoms to reduce the risk of HPV transmission and protect against trauma.
Proper awareness about EQ should be provided and its related causes with management strategies.
Appointments with a dermatologist and preventing recurrence of disorder is an ongoing life-long effort.
Dermatology, General
Topical 5-fluorouracil cream:
It inhibits DNA synthesis to block the thymidylate synthase enzyme.
Dermatology, General
Topical Imiquimod:
It stimulates the production of cytokines to enhance the local immune response against dysplastic cells.
Dermatology, General
Procedural interventions are essential with excisional surgery and Mohs micrographic surgery provide definitive treatment, while laser ablation, cryotherapy, and photodynamic therapy indicated as less invasive options.
Dermatology, General
In the initial treatment phase, evaluation of medical history, physical examination and diagnostic test are conducted to confirm diagnosis.
Pharmacologic therapy is effective in the treatment phase as it includes use of antineoplastic agents and Immune response modifiers.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.
The regular follow-up visits with the dermatologist are scheduled to check the improvement of patients along with treatment response.
Erythroplasia of Queyrat (EQ) is a type of squamous cell carcinoma on the penis that affects the glans and prepuce.
It is found in uncircumcised men and can progress to invasive carcinoma. Tarnovsky first described EQ in 1891 and later it is recognized as penile disease in 1893.
Sulzberger and Satenstein identified it as carcinoma in situ in 1933. Erythroplasia of Queyrat refers to penile mucocutaneous epithelium squamous cell carcinoma in situ.
It is characterized due to their red and velvety appearance. Distinct clinical entity acknowledged for unique presentation and related risk factors.
Strong connection exists between emotional intelligence and high-risk HPV infections. People with weakened immune systems those with HIV at higher EQ risk.
Uncommon EQ accounts for <1% male malignancies reported. It affects middle-aged to elderly males aged between 20 to 80 years old.
EQ is uncommon but more common in uncircumcised men also seen in women to affect the vulva region.
EQ stems from keratinocyte dysplastic changes with nuclear atypia and abnormal differentiation confined to epithelial layer.
HPV infection causes chronic inflammation, abnormal cell growth, and genetic instability. HPV-infected or dysplastic cells thrive due to immune system absence.
Patients with HIV or on immunosuppressive therapy at increased risk for cancer.
Dysplastic cells release pro-angiogenic factors to attract blood vessels for growth. Metabolic changes help dysplastic keratinocytes survive in harsh conditions.
The causes of EQ are:
Lack of circumcision
Zoon balanitis
Immunosuppression
UV light
Phimosis
Multiple sexual partners
Early detection and treatment of EQ results in high cure rates but urethral involvement complicates treatment and increases recurrence.
Graham and Helwig found 10% of Queyrat lesions can transform into invasive carcinoma.
Generally good prognosis with treatment but monitor closely for potential malignant transformation risk.
Collect details including history of present illness, presenting symptom, and medical history to understand clinical history of patient.
Skin and Mucosal Examination
Assessment of Lymph Nodes
Examination of Adjacent Structures
Ulceration, bleeding, involvement of the urethra, dysuria or urinary discomfort, pain during intercourse
Balanoposthitis
Basal Cell Carcinoma
Cutaneous Squamous Cell Carcinoma
Irritant Contact Dermatitis
Lichen Planus
A photosensitizing agent is applied to the lesion to induce cytotoxic effects.
Surgical options are recommended for larger, recurrent, or poorly responsive lesions about invasive SCC.
Patients should be monitored every 3 to 6 months to detect recurrence and progression.
Use immunomodulator to stimulate the production of interferons and cytokines that increases immune response against the lesion.
Prognosis is good with treatment but must monitor for malignant transformation risk.
Dermatology, General
Genital area should be wash with mild, fragrance-free soap and water.
Ensure the genital region stays moisture-free to prevent fungal infections.
Use non-irritating personal care products and use cotton-based undergarments to reduce sweating and friction.
Avoid tight underwear or pants to reduce friction and irritation of the lesion.
Avoid intercourse until lesion healing is confirmed to prevent irritation and potential spread of infection.
Encourage the use of condoms to reduce the risk of HPV transmission and protect against trauma.
Proper awareness about EQ should be provided and its related causes with management strategies.
Appointments with a dermatologist and preventing recurrence of disorder is an ongoing life-long effort.
Dermatology, General
Topical 5-fluorouracil cream:
It inhibits DNA synthesis to block the thymidylate synthase enzyme.
Dermatology, General
Topical Imiquimod:
It stimulates the production of cytokines to enhance the local immune response against dysplastic cells.
Dermatology, General
Procedural interventions are essential with excisional surgery and Mohs micrographic surgery provide definitive treatment, while laser ablation, cryotherapy, and photodynamic therapy indicated as less invasive options.
Dermatology, General
In the initial treatment phase, evaluation of medical history, physical examination and diagnostic test are conducted to confirm diagnosis.
Pharmacologic therapy is effective in the treatment phase as it includes use of antineoplastic agents and Immune response modifiers.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.
The regular follow-up visits with the dermatologist are scheduled to check the improvement of patients along with treatment response.
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