Carcinoma in situ of the penis

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 in 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.