Medicine (MD/DO)
Other Urologic Pathology
Penile Squamous Cell Carcinoma in Situ

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Penile Squamous Cell Carcinoma in Situ

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Penile Squamous Cell Carcinoma in Situ

Genital-gentleman and Square-mouse with Car-gnome and the Seat-(2)
Penile squamous cell carcinoma in situ comprise a group of closely associated diseases that are precancerous to penile cancer. Bowenoid papulosis is associated with HPV-16 infection and is characterized by multiple reddish-brown papules on the penis. This disease should be monitored for progression. Bowen disease is associated with HPV-16 and -18 infections as well as arsenic and high Sun exposure. Leukoplakia is a characteristic feature and fluorouracil is often an effective treatment. Erythroplasia of Queyrat is another precancerous lesion. It is associated with HPV-16 and -18 infections. An uncircumcised penis is a risk factor for this disease that presents as red papules or plaques.
Bowenoid Papulosis
Bow-droid Papule-people

Bowenoid papulosis is the transitional stage between genital warts and Bowen disease.

HPV 16
Human Puppet-virus with Sweet (16) Cake

Bowenoid papulosis is commonly associated with HPV 16.

Multiple Reddish-brown Papules
Multiple Red Papule-people

Bowenoid papulosis presents with multiple, flat reddish-brownish papules on the external genitalia (particularly the shaft, glans, foreskin, and perianal region).

Monitor for Progression
Security Camera Monitoring

Treatment of bowenoid papulosis involves re-examination every 3-6 months as the lesions often regress spontaneously. If the lesions are persistent, then local destruction therapy followed by surveillance (annual exams) is recommended as lesions may recur.

Bowen Disease

Bowen disease is a squamous cell carcinoma in situ of the penile skin. It typically impacts non-mucosal skin (vs. erythroplasia of Queyrat, which affects mucous membranes) anywhere on the body, including the penis.

HPV 16, 18
Human Puppet-virus with Sweet (16) Cake and (18) ID

Bowen disease is associated with HPV strains 16 and 18.

Arsenic and Sun Exposure
Arsenic Rat-poison and Sun

Bowen disease commonly occurs on skin that is either exposed to the Sun or arsenic, as these risk factors are associated with metaplasia and dysplasia.

White Plaque

Leukoplakia can be described as persistent white plaques that cannot be scraped off. The lesions can be irregularly shaped with sharply defined borders. Erythematous and scaly skin is often adjacent to these lesions.

Fluorouracil (5-FU)

Bowen disease along with erythroplasia of Queyrat can be treated with pharmacotherapy (e.g. 5-FU, imiquimod), photodynamic therapy, and surgical excision with margins.

Erythroplasia of Queyrat
Earth-red Quad-rat

Erythroplasia of Queyrat is squamous cell carcinoma in situ of the penile mucosa. It commonly affects the prepuce and glans penis.

HPV 16, 18
Human Puppet-virus with Sweet (16) Cake and (18) ID

Erythroplasia of Queyrat is associated with HPV strains 16 and 18.

No-sign on Circus Incision

A lack of circumcision along with chronic irritation or infection is associated with erythroplasia of Queyrat.

Red Papules or Plaques
Red Papule-people holding Plaque

Erythroplasia of Queyrat presents with erythroplakia as single or multiple sharply demarcated, non-healing lesions (e.g. plaques or red papules). These lesions may ulcerate and bleed easily.


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