Efficacy of topical photodynamic therapy in the treatment of Erythroplasia of Queyrat

Massimo Iafrate; Mariangela Mancini; Tommaso Prayer Galetti; Serena Szekely; Edoardo Zattra; Daniele Vaccari; Stefano Piaserico

doi:10.4081/dr.2020.8566

Efficacy of topical photodynamic therapy in the treatment of Erythroplasia of Queyrat

Dermatol Reports. 2020 Jun 25;12(1):8566. doi: 10.4081/dr.2020.8566.

Authors

Massimo Iafrate¹, Mariangela Mancini¹, Tommaso Prayer Galetti¹, Serena Szekely², Edoardo Zattra², Daniele Vaccari², Stefano Piaserico²

Affiliations

¹ Urology Clinic, Department of Surgery, Oncology and Gastroenterology - Urology Clinic, University of Padua.
² Unit of Dermatology, Department of Medicine, University of Padova, Padua, Italy.

Abstract

Erythroplasia of Queyrat (EQ) is an intraepidermal carcinoma in situ presenting clinically as a sharply demarcated, slightly raised erythematosus plaque on the glans penis or the inner side of the foreskin. Various treatment modalities for EQ have been proposed, including electrocautery and curettage, topical 5-floururacil cream, imiquimod cream, isotretinoin, cryotherapy, laser therapy, radiotherapy, ingenol mebutate gel and Photodynamic Therapy (PDT). Most of these treatments are limited by low clearance rates and frequent relapses. Surgical treatment including local excision, Mohs micrographic surgery and partial or total penectomy, ensures adequate healing rates. However, discomfort consequent to surgical treatment might be unacceptable. Topical PDT using the methyl ester of 5- aminolaevulinic acid (MAL) is an established non-surgical treatment of cutaneous precancerous lesions and skin cancers. We present the case of a 60-year-old uncircumcised man affected by EQ of the penis successfully treated with MAL-PDT, performed five times, two weeks apart, with no recurrences after 6 years.

Keywords: Erythroplasia of Queyrat; carcinoma in situ; photodynamic therapy.