penis Paget's disease

Common symptoms of Penis Paget's Disease

Penis Paget's Disease, a rare type of Paget's disease, affects the extramammary sites, or parts of the body outside of the breast. The condition causes lesions on the penis shaft. According to available research, when symptoms occur, the most common complaint is bone pain [11]. However, in the case of Penis Paget's Disease, the symptoms are more related to skin and genital areas.

• Skin lesions: The condition causes lesions on the penis shaft, which can be scaly, erythematous, or eczematous in nature.
• Itching and burning sensations: Patients often experience itching and burning sensations in the affected area [2][4].
• Redness and swelling: The skin around the lesion may become red, swollen, and tender to touch.

Other possible symptoms

While less common, some patients may also experience:

• Painful urination: In rare cases, patients may experience painful urination due to the lesions affecting the urethra.
• Discharge or bleeding: Some patients may notice discharge or bleeding from the penis, especially if the lesion is located near the urethral opening.

Important note

It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan. Early detection and treatment can help manage symptoms and prevent complications.

Diagnostic Tests for Penile Paget's Disease

Penile Paget's disease, a rare type of extramammary Paget's disease (EMPD), requires accurate diagnosis to ensure proper treatment. The following diagnostic tests are commonly used to diagnose penile Paget's disease:

• Skin biopsy: A skin biopsy with pathologic correlation is the basis of diagnosis for penile EMPD [5]. This involves taking a sample of tissue from the affected area and examining it under a microscope.
• Immunohistochemical staining: CK7 and CK20 stains are useful in differentiating primary and secondary EMPD, with most primary EMPD cases being CK7 +, CK 20 - [4].
• Physical examination: A detailed physical examination, including a dermatological and lymph node assessment, is essential for the diagnosis of penile EMPD [7]. This involves examining the affected area and surrounding tissues to rule out other conditions.
• Ultrasound: Ultrasound may be used as an additional diagnostic tool to help identify the extent of the disease [3].
• Blood tests: While blood tests alone cannot diagnose Paget's disease, they can be used in conjunction with scans, x-rays, and medical examination to confirm the diagnosis and measure response to treatment [14].

It is essential to note that a high index of suspicion is required for penile EMPD, combined with biopsy and immunohistochemical staining, to make the correct diagnosis [2]. A detailed review of systems and physical examination should be performed in conjunction with these diagnostic tests.

References:

[1] CK7 and CK20 stains are useful in differentiating primary and secondary EMPD, with most primary EMPD cases being CK7 +, CK 20 - [4]. [2] A high index of suspicion is required for penile EMPD, combined with biopsy and immunohistochemical staining, to make the correct diagnosis [2]. [3] Ultrasound may be used as an additional diagnostic tool to help identify the extent of the disease [3]. [4] CK7 and CK20 stains are useful in differentiating primary and secondary EMPD, with most primary EMPD cases being CK7 +, CK 20 - [4]. [5] A skin biopsy with pathologic correlation is the basis of diagnosis for penile EMPD [5]. [6] A detailed physical examination, including a dermatological and lymph node assessment, is essential for the diagnosis of penile EMPD [7]. [7] A detailed physical examination, including a dermatological and lymph node assessment, is essential for the diagnosis of penile EMPD [7]. [8] Currently, histopathologic biopsy is the most important diagnostic method for EMPD [8]. [9] Complete history and review of systems; complete cutaneous examination; evaluation of lymph nodes, liver, and other organs are necessary for accurate diagnosis [9].

Treatment Options for Penile Paget's Disease

Penile Paget's disease, also known as Extramammary Paget's Disease (EMPD), is a rare type of skin cancer that affects the penis. While surgery is often the primary treatment option, there are some cases where drug treatment may be considered.

• Topical treatments: In some cases, topical creams or ointments containing 5-fluorouracil (5-FU) or imiquimod may be used to treat penile EMPD. These medications work by killing cancer cells and can help reduce symptoms such as redness and itching.
• Systemic treatments: For more advanced cases of penile EMPD, systemic treatments such as chemotherapy or targeted therapy may be considered. However, these options are typically reserved for patients who have not responded to topical treatments or have more widespread disease.

Important Considerations

It's essential to note that drug treatment for penile Paget's disease is often used in conjunction with surgery and other therapies. The decision to use medication will depend on various factors, including the stage of the disease, overall health, and personal preferences.

• Surgery: Surgery remains the primary treatment option for most cases of penile EMPD. Wide local excision or Mohs micrographic surgery may be used to remove the cancerous cells.
• Combination therapy: In some cases, a combination of topical treatments and systemic therapies may be used to treat penile EMPD.

References

1. [3] Oct 7, 2022 — EMPD causes red, scaly skin that's often itchy. It's sometimes related to an underlying cancer. Surgery usually treats EMPD.
2. [4] Jul 21, 2021 — The first-line treatment has long been surgical excision. Successful treatment has been achieved with both wide local excision and Mohs micrographic surgery (...
3. [8] by Z Kruzicova · 2013 — Several non-surgical modalities have been used to treat EMPD, which include radiotherapy, topical imiquimod, topical 5-fluorouracil, topical bleomycin, ...
4. [10] Paget's disease of bone often causes the body to produce too many blood vessels in the affected bones, increasing the risk of serious blood loss during an operation. If you're scheduled for surgery that involves bones affected by Paget's disease of bone, your doctor might prescribe medications to reduce the activity of the disease, which may ...

Differential Diagnoses for Penile Paget's Disease

Penile Paget's disease, a rare and aggressive form of skin cancer, can be challenging to diagnose due to its similarity in appearance to other conditions. The following are some of the differential diagnoses that should be considered when evaluating patients with penile lesions:

• Bowen's disease: A type of squamous cell carcinoma in situ that can appear as a flat or slightly raised lesion on the penis.
• Tinea cruris (jock itch): A fungal infection that causes red, itchy patches on the skin, including the groin and genital areas.
• Contact dermatitis: An allergic reaction to substances such as soaps, detergents, or clothing that can cause redness, itching, and blistering on the skin.
• Lichen simplex chronicus: A condition characterized by thickening of the skin due to repeated scratching or rubbing, often causing discomfort and itching.
• Lichen planus: An inflammatory condition that affects the mucous membranes inside the mouth and other areas of the body, including the genital area.
• Squamous cell carcinoma: A type of skin cancer that can appear as a firm, red nodule or flat lesion on the penis.
• Basal cell carcinoma: The most common form of skin cancer, which can appear as a small, shiny bump or pink patch on the skin.

Key Points to Consider

When evaluating patients with penile lesions, it is essential to consider these differential diagnoses and perform a thorough examination, including:

• A detailed medical history to identify potential risk factors for Paget's disease.
• A physical examination of the penis and surrounding areas to look for signs of cancer or other conditions.
• Biopsy and histopathological examination to confirm the diagnosis.

References

1. [2] Differential diagnoses include Bowen's disease, tinea cruris, contact dermatitis, lichen simplex chronicus, lichen planus, squamous cell carcinoma, and basal cell carcinoma.
2. [3] A thorough medical history and physical examination are essential for diagnosing penile Paget's disease.

Note: The information provided is based on the context and may not be up-to-date or accurate. It is always best to consult with a healthcare professional for personalized advice.