Recurrent balanoposthitis, dermatoses and oncological diseases of the anogenital zone

Introduction. Oncological diseases of the anogenital zone in men have become increasingly relevant in recent years. It is associated with the increasing incidence, subtle clinical manifestations, and difficulties in establishing a diagnosis, requiring, in most cases, histological examination, since the diagnostic capabilities of non-invasive methods, unfortunately, are limited. Precancerous conditions, both associated with the human papillomavirus (HPV) and HPV-negative, occupy a special place among penile oncological disorders, timely diagnosis of which is extremely important.

Aim. To determine the frequency of precancerous and malignant diseases of the penis in the general structure of anogenital dermatoses in men, as well as to describe their main clinical features.

Materials and methods. The results of a survey of 160 men aged 18 to 86 years with various dermatoses of the anogenital zone who seek medical help in dermatological or urological departments are presented in the article.

Results. Various forms of penile squamous cell carcinoma were detected in 17 (10.6%), and precancerous conditions were detected in 21 (13.1%) cases. Among the latter, HPV-associated subtype of penile intraepithelial neoplasia (bowenoid papulosis, Bowen's disease, erythroplasia of Queyrat) was diagnosed in 19 (11.8%) patients. Objective symptoms were characterized by a variety of morphological and clinical manifestations. The list of incorrect clinical diagnoses which patients are followed with included banal balanoposthitis, lichen sclerosis, psoriasis, lichen planus, leukoplakia, and papillomatous nevus, which are characterized by a recurrent course and low efficiency of therapy. Histological examination was required to confirm the diagnosis of squamous cell carcinoma and precancerous diseases.

Conclusions. The oncological alertness of urologists and dermatologists in patients with chronic recurrent processes of the external genitalia is justified. If there is any doubt, tissue biopsy for morphological diagnostics should be done.