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Journal of Dermatological Treatment Volume 33, 2022 - Issue 2
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Articles

The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature

G. Kravvasa Department of Dermatology, University College London Hospitals, London, UKCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-1924-0149
ORCID Icon,
L. Gea Department of Dermatology, University College London Hospitals, London, UKORCID Iconhttps://orcid.org/0000-0003-3074-7538
ORCID Icon,
J. Ngb Department of Dermatology, Chelsea & Westminster Hospital, London, UK
,
T. N. Shima Department of Dermatology, University College London Hospitals, London, UKORCID Iconhttps://orcid.org/0000-0001-8967-9811
ORCID Icon,
P. R. Doirona Department of Dermatology, University College London Hospitals, London, UK
,
R. Watchorna Department of Dermatology, University College London Hospitals, London, UK
,
J. Kentleyb Department of Dermatology, Chelsea & Westminster Hospital, London, UKORCID Iconhttps://orcid.org/0000-0002-7109-6199
ORCID Icon,
E. Panoua Department of Dermatology, University College London Hospitals, London, UKORCID Iconhttps://orcid.org/0000-0002-8869-3889
ORCID Icon,
M. Dinneenc Department of Urology, Chelsea & Westminster Hospital, London, UK
,
A. Freemand Department of Histopathology, University College London Hospitals, London, UK
,
C. Jamesond Department of Histopathology, University College London Hospitals, London, UK
,
A. Haiderd Department of Histopathology, University College London Hospitals, London, UK
,
N. Francise Department of Histopathology, Imperial College Hospitals, London, UK
,
S. Minhasf Department of Urology, Imperial College Hospitals, London, UK
,
H. Alnajjarg Department of Urology, University College London Hospitals, London, UKORCID Iconhttps://orcid.org/0000-0001-6364-0310
ORCID Icon,
A. Muneerg Department of Urology, University College London Hospitals, London, UKORCID Iconhttps://orcid.org/0000-0003-2958-1614
ORCID Icon &
C. B. Bunkera Department of Dermatology, University College London Hospitals, London, UK;b Department of Dermatology, Chelsea & Westminster Hospital, London, UKORCID Iconhttps://orcid.org/0000-0002-6693-7483
ORCID Icon show all
Pages 1047-1062 | Received 03 Jul 2020, Accepted 12 Jul 2020, Published online: 06 Aug 2020
 
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Abstract

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.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Author contribution

All authors contributed to the management, writing, and literature review associated with this study

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 All results have been rounded to one decimal place

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