Abstracts

1. Gerber GS. Carcinoma in situ of the penis. J Urol. 1994 Apr;151(4):829-33.

Department of Surgery, University of Chicago Pritzker School of Medicine, Illinois.

Bowen's disease, erythroplasia of Queyrat and bowenoid papulosis are uncommon disorders of the anogenital skin that may be confused with a variety of other lesions. While all appear histologically as carcinoma in situ and are strongly associated with human papillomavirus infection, only Bowen's disease and erythroplasia of Queyrat have been demonstrated to lead to the development of invasive squamous cell carcinoma. In contrast, bowenoid papulosis has a completely benign course with no present evidence suggesting the potential for malignant degeneration. The standard treatment for all 3 lesions is surgical excision, although use of the carbon dioxide or neodymium:YAG laser appears to be effective at obtaining local control of disease while achieving an excellent cosmetic result. Alternative treatments with micrographic surgery, topical 5-fluorouracil or radiotherapy have a more limited role. It is important to remember that adequate biopsies are always necessary to ensure a complete and accurate diagnosis, and allow for proper treatment and followup, as well as appropriate counseling of sexual partners.

2. Kessler GM, Ackerman AB. Nomenclature for very superficial squamous cell carcinoma of the skin and of the cervix: a critique in historical perspective. Am J Dermatopathol. 2006 Dec;28(6):537 - 45

Ackerman Academy of Dermatopathology, 145 E 32 St, Fl 10, New York, NY 10016, USA. abernard@ameripath.com

Squamous-cell carcinoma is the most common of all cancers and it develops in diverse organs of the body, among those being the skin, lung, gastrointestinal tract, and genitourinary tract, the latter including the cervix. Unfortunately, no unanimity exists for naming very superficial squamous-cell carcinoma; it has not been designated in consistent fashion in a single organ, let alone in all of them, thereby resulting in confusion, not only in regard to terminology per se, but concerning matters conceptual, not the least of those being what appellation to apply to that condition when it is encountered histopathologically. This vexing situation is illustrated graphically in the skin by diagnoses for very superficial squamous-cell carcinoma as disparate as solar keratosis (actinic keratosis, senile keratosis), arsenical keratosis, radiation keratosis, Bowen disease, bowenoid papulosis, squamous-cell carcinoma in situ, as well as variations on the theme of "keratinocytic intraepidermal neoplasia" and "dysplasia," and in the cervix by squamous-cell carcinoma in situ, leukoplakia, cervical intraepithelial neoplasia I-III, as well as variations on the theme of "squamous dysplasia ()." What follows now is a recounting of the history of the subject under consideration here, a critique of dizzying, opaque terms and phrases given to that subject, and a proposal for rectifying what currently is a thoroughly untenable situation because the language, and the ideas expressed by it, are impenetrable to physicians and, thereby, are decidedly disadvantageous to patients. There is a need urgently for a single term for very superficial squamous-cell carcinoma in every organ of the body in which it develops, to wit, one that conveys diagnosis in such logical, lucid, comprehensible fashion that it is understandable, readily and immediately, to clinicians. In that way, physicians charged with management of patients can plan therapy rationally.

3. Goorney BP, Polori R. A case of Bowenoid papulosis of the penis successfully treated with topical imiquimod cream 5%. Int J STD AIDS. 2004 Dec;15(12):833-5

Department of Genito-Urinary Medicine, Hope Hospital, Stott Lane, Manchester M6 8HD, UK. benjamin.goorney@srht.nhs.uk

Bowenoid papulosis is a pre-malignant condition affecting the ano-genital area. Pathogenesis may be associated with high-risk human papillomavirus genotypes, and sexual transmission is the most likely mode of acquisition. Risk of progression to invasive disease is low. Treatment usually involves locally destructive or ablative therapies. We report well-tolerated, successful clearance of bowenoid papulosis of the penis in a 25-year-old male, using topical Aldara (imiquimod) cream 5%, once every other day for two months

4. Eisen R, Bhawan J, Cahn T. Spontaneous resolution of Bowenoid Papulosis of the penis. Cutis 1983; Vol 32: 269-73

In the last decade, bowenoid papulosis of the genitalia has been recognized to be a distinct entity. It is distinguished from Bowen's disease, which it resembles histologically, on the basis of clinical data such as onset at an earlier average age, smaller size of lesions, and multiplicity of lesions. A 23-year-old man with bowenoid papulosis
of the penis is presented. The lesions were present for two months prior to diagnosis. All of the lesions resolved without treatment within two months of diagnosis. A conservative approach to treatment of this condition is advocated.

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