An Erythematous Patch on Glans Penis

CASE REPORT The 76 year-old uncircumcised male noticed an asymptomatic pea-sized erythematous patch on his glans penis 9 months ago. He received some topical medication over the lesion from the local clinics but there was no improvement. The lesion progressed in size gradually. He visited local hospital 2 months ago and an incisional biopsy was performed. The pathological result revealed erythroplasia of Queyrat. Topical imiquimod cream 5% was prescribed. However, pain and erosion occurred after the use of imiquimod. Then he visited our hospital for second opinion. After admission, an ill-defi ned erythematous plaque, 3 cm in diameter, with a central 0.5 cm ulcer was found to involve the glans penis, corona and sulcus (Fig. 1). Wide excision and advancement fl ap were performed. Histologically, disorganization of the epithelium, atypical cells, and several individually keratinized cells appeared throughout the full thickness of the epidermis (Fig. 2). No invasion was observed beyond the basement membrane. Mild perivascular lymphocytic infi ltrates over the upper dermis were also noted. A survey of HPV DNA in the lesion was carried out using the commercial HPV blot detection kit (Easychip, King Car Food Industrial Co., Ltd. Yuan-Shan Research Institute, Taiwan) and HPV type 16 DNA was detected. Resident Forum