Incidence of basal and squamous cell carcinoma is increasing among Korean. With increasing this incidence we need to attend the management and prevention of these cutaneous malignancies. Basal cell carcinoma (BCC) is the most common skin malignancy. Sun exposure is the most important environmental cause of BCC. Daily sun protection especially avoiding sun exposure between 10 a.m. and 4 p.m. provides most effective prevention against chronic ultraviolet-induced skin damage. Hedgehog pathway inhibitors are used locally advanced and metastatic BCC lesions in Korea. Until recently, there are no reports whether it developed resistance of Hedgehog pathway inhibitors with advanced BCC in Korean patients. Among malignant skin tumors, 19.1% were squamous cell carcinoma (SCC). The incidence of SCC was rapidly increased over the past years. However, the incidence rate of SCC in Japan has not been changed from the period 1976–1980 to 1986–1990. Sentinel lymph node biopsy for SCC did not provide diagnostic value. Bowen's disease and Erythroplasia of Queyrat are considered as carcinoma in situ of the skin. Erythroplasia of Queyrat have worse prognosis with a higher rate of malignant degeneration. Dermoscopy may helpful tool in assisting the noninvasive diagnosis of carcinoma in situ of the skin.
Bowen's Disease ; Carcinoma in Situ ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermoscopy ; Diagnosis ; Epithelial Cells ; Erythroplasia ; Hedgehogs ; Humans ; Incidence ; Japan ; Korea ; Prognosis ; Sentinel Lymph Node Biopsy ; Skin ; Solar System

BACKGROUND: A variety of infectious, inflammatory, and neoplastic dermatoses can develop on the glans penis, and definitive diagnosis in such cases may be difficult owing to their non-specific symptoms and clinical appearance. Furthermore, data on dermatoses of the glans penis in Korea are limited. OBJECTIVE: In the present study, we aimed to determine the prevalence of dermatoses of the glans penis in Korea and provide clinical data to assist in making an accurate diagnosis. METHODS: We retrospectively reviewed the medical records, clinical photographs, and histologic slides of 65 patients with dermatoses of the glans penis that visited the Pusan National University Hospital between January 2004 and August 2013. RESULTS: Twenty-six types of dermatoses were identified: inflammatory dermatosis was the most common (38/65, 58.5%), followed by infectious (13/65, 20.0%), neoplastic (10/65, 15.4%), and other dermatoses (4/65, 6.2%). The most common dermatosis of the glans penis was seborrheic dermatitis, followed by lichen planus, herpes progenitalis, condyloma accuminatum, erythroplasia of Queyrat, Zoon's balanitis, and psoriasis. In the topographic analysis, the most common type of dermatosis was dermatoses that localized to the glans penis (39/65, 60.0%), followed by dermatoses involving the extra-genitalia and glans penis (22/65, 33.9%), and the genitalia (glans penis plus other genital areas) (4/65, 6.2%). CONCLUSION: This study shows the usefulness of a topographic approach in the diagnosis of dermatoses of the glans penis in Korea. The findings could be used as baseline data for establishing an accurate diagnosis in Koreans.
Balanitis ; Busan ; Dermatitis, Seborrheic ; Diagnosis ; Erythroplasia ; Genitalia ; Humans ; Korea* ; Lichen Planus ; Male ; Medical Records ; Penis* ; Prevalence ; Psoriasis ; Retrospective Studies ; Skin Diseases*

Optical spectroscopy devices are being developed and tested for the screening and diagnosis of oral precancer and cancer lesions. This study reports a device that uses white light for detection of suspicious lesions and green-amber light at 545 nm that detect tissue vascularity on patients with several suspicious oral lesions. The clinical grading of vascularity was compared to the histological grading of the biopsied lesions using specific biomarkers. Such a device, in the hands of dentists and other health professionals, could greatly increase the number of oral cancerous lesions detected in early phase. The purpose of this study is to correlate the clinical grading of tissue vascularity in several oral suspicious lesions using the Identafi(®) system with the histological grading of the biopsied lesions using specific vascular markers. Twenty-one patients with various oral lesions were enrolled in the study. The lesions were visualized using Identafi(®) device with white light illumination, followed by visualization of tissue autofluorescence and tissue reflectance. Tissue biopsied was obtained from the all lesions and both histopathological and immunohistochemical studies using a vascular endothelial biomarker (CD34) were performed on these tissue samples. The clinical vascular grading using the green-amber light at 545 nm and the expression pattern and intensity of staining for CD34 in the different biopsies varied depending on lesions, grading ranged from 1 to 3. The increase in vascularity was observed in abnormal tissues when compared to normal mucosa, but this increase was not limited to carcinoma only as hyperkeratosis and other oral diseases, such as lichen planus, also showed increase in vascularity. Optical spectroscopy is a promising technology for the detection of oral mucosal abnormalities; however, further investigations with a larger population group is required to evaluate the usefulness of these devices in differentiating benign lesions from potentially malignant lesions.
Adult ; Aged ; Aged, 80 and over ; Antigens, CD34 ; analysis ; Biomarkers, Tumor ; analysis ; Biopsy ; methods ; Carcinoma, Squamous Cell ; blood supply ; diagnosis ; pathology ; Erythroplasia ; diagnosis ; pathology ; Female ; Humans ; Immunohistochemistry ; Leukoplakia, Oral ; blood supply ; diagnosis ; pathology ; Lichen Planus, Oral ; diagnosis ; pathology ; Male ; Middle Aged ; Mouth Neoplasms ; blood supply ; diagnosis ; pathology ; Neoplasm Grading ; Optical Imaging ; methods ; Pilot Projects ; Precancerous Conditions ; blood supply ; diagnosis ; pathology ; Spectrometry, Fluorescence ; methods ; Young Adult

Imiquimod is a new immunomodulating agent with antitumor and antiviral properties that has been shown to be clinically effective in various kinds of skin diseases, including precancerous dermatoses. Erythroplasia of Queyrat is a carcinoma in situ that mainly occurs on the glans penis. There are several non-invasive treatment options for erythroplasia of Queyrat such as photodynamic therapy, cryosurgery and applying various kinds of topical agents. We now report a case of typical erythroplasia of Queyrat on glans penis associated with human papillomavirus type 16 infection that was treated by imiquimod 5% cream and the subsequent excision of an imiquimod-resistant penile lesion.
Aminoquinolines ; Carcinoma in Situ ; Cryosurgery ; Erythroplasia ; Humans ; Male ; Penis ; Photochemotherapy ; Skin Diseases

A 47-year-old woman presented with a large, gray, verrucous plaque rapidly growing on the vulva for 8 months. Histopathologically, the lesion showed a marked hyperkeratosis, acanthosis, papillomatosis, and dysregulated epidermal hyperplasia with atypical hyperchromatic cells. The basement membrane zone remained intact. Human papilloma virus type 16 and 18 was detected in the lesional area by in situ hybridization. Based on these findings, the lesion was identified as vulvar intraepithelial neoplasia (VIN). Although vulvar lesions are examined by both dermatologists and gynecologists, their diagnostic jargon of the verrucous, hyperplastic plaque that shows intraepithelial neoplasia, is not always concordant. We believe that VIN could be a better substitute for large bowenoid papulosis, Bowen's disease or vulvar erythroplasia of Queyrat.
Basement Membrane ; Bowen's Disease ; Erythroplasia ; Female ; Humans ; Hyperplasia ; In Situ Hybridization ; Middle Aged ; Papilloma ; Vulva

Erythroplasia ; diagnosis ; epidemiology ; therapy ; Humans ; Leukoplakia, Oral ; diagnosis ; epidemiology ; therapy ; Mouth Mucosa ; pathology

OBJECTIVETo study the relationship between the infection of human papillomavirus (HPV) and external genital squamous cell carcinoma in situ.

METHODSHPV DNA was detected with the consensus primer by polymerase chain reaction (PCR) and its type was determined by restriction fragment length polymorphism (RFLP).

RESULTSHPV DNA was detected and HPV16 was the most frequently identified type in 29 (56.9%) of 51 cases of external genital squamous cell carcinoma in situ. HPV DNA was positive in 22 (55%) of 40 cases of bowenoid papulosis, among which 20 were of HPV16 type, one of HPV31 type, and one of HPV6 + 16 type. HPV DNA was positive in all 5 cases (100%) of Bowen's disease, among which 4 were HPV16 type and one of HPV6 + 16 type. HPV DNA was positive in 2 (33.3%) of 6 Queyrat erythroplasia cases and all were of HPV16 type.

CONCLUSIONHPV16 infection is strongly associated with the external genital squamous cell carcinoma in situ including bowenoid papulosis, Bowen's disease, and Queyrat erythroplasia.

Adult ; Aged ; Bowen's Disease ; virology ; Carcinoma in Situ ; virology ; Carcinoma, Squamous Cell ; virology ; DNA Probes, HPV ; DNA, Viral ; analysis ; Erythroplasia ; virology ; Female ; Genital Neoplasms, Female ; virology ; Genital Neoplasms, Male ; virology ; Humans ; Male ; Middle Aged ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; virology ; Penile Neoplasms ; virology ; Polymorphism, Restriction Fragment Length ; Tumor Virus Infections ; virology ; Vulvar Neoplasms ; virology

Erythroplasia of Queyrat is an uncommon intraepithelial carcinoma in situ affecting the mucosal surface of the penis with a significant risk of invasion. Treatment is often difficult and is associated with significant recurrence rates. Topical 5-fluorouracil treatment is very effective and regarded as the treatment of choice for histologically confirmed erythroplasia of Queyrat because of its superior results compared with those of surgery or radiation therapy. We report a typical case of erythroplasia of Queyrat involving the mucosa of the glans penis in a 64-year-old male patient who was treated by topical 5% 5-Fluorouracil cream and has achieved a long-term complete response and no recurrence after 12months.
Carcinoma in Situ ; Erythroplasia* ; Fluorouracil* ; Humans ; Male ; Middle Aged ; Mucous Membrane ; Penis ; Recurrence

In 1952, Zoon described eight cases of benign circumscribed chronic balanitis characterized by an extensive infiltration of plasma cells with no evidence of dysplasia of the overlying epidermis. Plasma cell balanitis can often be confused clinically with other conditions, such as erythroplasia of Queyrat, fixed drug eruptions, secondary syphilis, candidiasis and Reiters disease. We report a case of plasma cell balanitis in a 65-year-old man. He complained of a single, red, shiny and smooth patch involving the glans penis and adjacent prepuce. This patch was unresponsive to systemic and topical steroid treatment. Laboratory studies were negative or within the normal range. Histopathological findings showed a band-like mainly plasmacytic inflammatory infiltrate of the upper dermis. This patient was treated once daily with 2% fusidic acid cream topically for 5 weeks. The lesions resolved and no recurrence was observed during 2 years of follow-up.
Aged ; Arthritis, Reactive ; Balanitis* ; Candidiasis ; Dermis ; Drug Eruptions ; Epidermis ; Erythroplasia ; Follow-Up Studies ; Furosemide* ; Fusidic Acid* ; Humans ; Male ; Penis ; Plasma Cells* ; Plasma* ; Recurrence ; Reference Values ; Syphilis

BACKGROUND: The incidence of cutaneous squamous cell carcinoma(SCC) has been increasing, but no analysis of the causative diseases of cutaneous SCC has been performed. OBJECTIVE: The purpose of this study was to investigate the causative disease of SCC. METHODS: Eighty-seven patients with cutaneous SCC were retrospectively studied. RESULTS: The possible causative diseases of cutaneous SCC were actinic keratosis(18 csaes), Bowen's disease(17 cases), actinic cheilitis(8 cases), burn scar(4 cases), arsenical keratosis(3 cases), xeroderma pigmentosum(3 cases), chronic discoid lupus erythematosus(2 cases), epidermodysplasia verruciformis(2 cases), leukoplakia(1 case), chronic radiodermatitis(1 cases), erythroplasia of Queyrat (1 case), osteomyelitis sinus(1 case), lichen planus(1 case), porokeratosis of Mibelli(1 case), and the other 21 cases were of unknown origin. CONCLUSION: The causative diseases of cutaneous SCC were related to sun-exposure, and chronic dermatoses.
Actins ; Burns ; Carcinoma, Squamous Cell* ; Erythroplasia ; Humans ; Ichthyosis ; Incidence ; Lichens ; Osteomyelitis ; Porokeratosis ; Retrospective Studies ; Skin Diseases