The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature
Introduction Penile intraepithelial neoplasia (PeIN) is a histological term for precancerous penile lesions. PeIN is important due to the high morbidity and mortality associated with progression to penile squamous cell carcinoma (PSSC). But PeIN is rare, contributing to a limited evidence-base for t...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-02-01
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| Series: | Journal of Dermatological Treatment |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/09546634.2020.1800574 |
| _version_ | 1797683556738138112 |
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| author | G. Kravvas L. Ge J. Ng T. N. Shim P. R. Doiron R. Watchorn J. Kentley E. Panou M. Dinneen A. Freeman C. Jameson A. Haider N. Francis S. Minhas H. Alnajjar A. Muneer C. B. Bunker |
| author_facet | G. Kravvas L. Ge J. Ng T. N. Shim P. R. Doiron R. Watchorn J. Kentley E. Panou M. Dinneen A. Freeman C. Jameson A. Haider N. Francis S. Minhas H. Alnajjar A. Muneer C. B. Bunker |
| author_sort | G. Kravvas |
| collection | DOAJ |
| description | Introduction Penile intraepithelial neoplasia (PeIN) is a histological term for precancerous penile lesions. PeIN is important due to the high morbidity and mortality associated with progression to penile squamous cell carcinoma (PSSC). But PeIN is rare, contributing to a limited evidence-base for the relative efficacy of available treatment options. Objectives & methods To consolidate and expand knowledge about PeIN and its treatment, we describe the clinical and histological characteristics, treatments and outcomes of 345 patients with PeIN, managed by our multidisciplinary team. Our results are compared and contrasted with those in the literature, following comprehensive review. Results 8.7% of patients had concomitant, invasive PSCC, whilst 91.3% demonstrated PeIN alone. 84% had undifferentiated PeIN, and 10.7% differentiated PeIN (5.2%, not specified). Clinical or histological evidence of HPV alone was present in 58%; features of lichen sclerosus alone in 12%; features of both in 29.4%. Only 14.4% of patients could be treated solely with topical agents or cryotherapy, whereas the remaining 85.6% underwent some form of surgical intervention, circumcision being the mainstay. Just 2.6% progressed to PSCC. Conclusions Clinical management of PeIN can be rationally optimized with excellent outcomes. Circumcision is important. Topical treatments alone are disappointing. |
| first_indexed | 2024-03-12T00:15:58Z |
| format | Article |
| id | doaj.art-61e5509e923e46628b50fe8cdfb2c837 |
| institution | Directory Open Access Journal |
| issn | 0954-6634 1471-1753 |
| language | English |
| last_indexed | 2024-03-12T00:15:58Z |
| publishDate | 2022-02-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Dermatological Treatment |
| spelling | doaj.art-61e5509e923e46628b50fe8cdfb2c8372023-09-15T14:28:49ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532022-02-013321047106210.1080/09546634.2020.18005741800574The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literatureG. Kravvas0L. Ge1J. Ng2T. N. Shim3P. R. Doiron4R. Watchorn5J. Kentley6E. Panou7M. Dinneen8A. Freeman9C. Jameson10A. Haider11N. Francis12S. Minhas13H. Alnajjar14A. Muneer15C. B. Bunker16Department of Dermatology, University College London HospitalsDepartment of Dermatology, University College London HospitalsDepartment of Dermatology, Chelsea & Westminster HospitalDepartment of Dermatology, University College London HospitalsDepartment of Dermatology, University College London HospitalsDepartment of Dermatology, University College London HospitalsDepartment of Dermatology, Chelsea & Westminster HospitalDepartment of Dermatology, University College London HospitalsDepartment of Urology, Chelsea & Westminster HospitalDepartment of Histopathology, University College London HospitalsDepartment of Histopathology, University College London HospitalsDepartment of Histopathology, University College London HospitalsDepartment of Histopathology, Imperial College HospitalsDepartment of Urology, Imperial College HospitalsDepartment of Urology, University College London HospitalsDepartment of Urology, University College London HospitalsDepartment of Dermatology, University College London HospitalsIntroduction Penile intraepithelial neoplasia (PeIN) is a histological term for precancerous penile lesions. PeIN is important due to the high morbidity and mortality associated with progression to penile squamous cell carcinoma (PSSC). But PeIN is rare, contributing to a limited evidence-base for the relative efficacy of available treatment options. Objectives & methods To consolidate and expand knowledge about PeIN and its treatment, we describe the clinical and histological characteristics, treatments and outcomes of 345 patients with PeIN, managed by our multidisciplinary team. Our results are compared and contrasted with those in the literature, following comprehensive review. Results 8.7% of patients had concomitant, invasive PSCC, whilst 91.3% demonstrated PeIN alone. 84% had undifferentiated PeIN, and 10.7% differentiated PeIN (5.2%, not specified). Clinical or histological evidence of HPV alone was present in 58%; features of lichen sclerosus alone in 12%; features of both in 29.4%. Only 14.4% of patients could be treated solely with topical agents or cryotherapy, whereas the remaining 85.6% underwent some form of surgical intervention, circumcision being the mainstay. Just 2.6% progressed to PSCC. Conclusions Clinical management of PeIN can be rationally optimized with excellent outcomes. Circumcision is important. Topical treatments alone are disappointing.http://dx.doi.org/10.1080/09546634.2020.1800574bowen’s diseaseerythroplasia of queyratbowenoid papulosispenile intraepithelial neoplasiahuman papillomaviruslichen sclerosus |
| spellingShingle | G. Kravvas L. Ge J. Ng T. N. Shim P. R. Doiron R. Watchorn J. Kentley E. Panou M. Dinneen A. Freeman C. Jameson A. Haider N. Francis S. Minhas H. Alnajjar A. Muneer C. B. Bunker The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature Journal of Dermatological Treatment bowen’s disease erythroplasia of queyrat bowenoid papulosis penile intraepithelial neoplasia human papillomavirus lichen sclerosus |
| title | The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature |
| title_full | The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature |
| title_fullStr | The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature |
| title_full_unstemmed | The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature |
| title_short | The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature |
| title_sort | management of penile intraepithelial neoplasia pein clinical and histological features and treatment of 345 patients and a review of the literature |
| topic | bowen’s disease erythroplasia of queyrat bowenoid papulosis penile intraepithelial neoplasia human papillomavirus lichen sclerosus |
| url | http://dx.doi.org/10.1080/09546634.2020.1800574 |
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