Erythema proliferative

Introduction to proliferative erythema Erythroplasia of erythematosus is a rare precancerous condition characterized by a localized, moist, and radiant red plaque on the glans or foreskin that develops slowly and develops epithelial-like carcinoma over time. Patients with this disease should be routinely removed. There is currently no positive opinion on the treatment of proliferative erythema. Some scholars advocate the removal of the foreskin and close observation; some doctors advocate freezing or X-ray irradiation of lesions. basic knowledge The proportion of the disease: the incidence rate is about 0.005% - 0.009%, more common in women Susceptible people: no specific population Mode of infection: non-infectious Complications: dermatitis

Proliferative erythema

The foreskin is too long (75%):

The cause of proliferative erythema is unknown, but it mainly occurs in people with too long prepuce, so it is considered to be related to excessive foreskin and smegma stimulation. The author has done circumcision for several patients with this disease, and several of them have disappeared naturally. Therefore, patients with this disease should be routinely removed the foreskin.

Pathogenesis

The mucosal epithelium is often involved in the whole layer, and the boundary with the surrounding normal part is obvious. The tissue resembles skin carcinoma in situ. The histopathological features are hypertrophy of the epithelial cells in the papilla, forming a slender epidermal process, which grows like a finger down to the dermis. However, the basement membrane is intact, the vasculature is dilated in the dermis, and the lymphocytes and plasma cells are infiltrated. In the proliferating epithelium, many abnormal epithelial cells, deep nuclear staining, or multinuclear, giant tumor cells and keratinocytes are seen. Less common.

Proliferative erythema prevention

1. Based on high protein, high vitamin, high cellulose, high calorie and low fat diet, spicy foods such as pepper, raw onion and raw garlic can aggravate the internal heat of patients and should not be eaten. It is absolutely forbidden to smoke or drink alcohol.

2. Avoid any local irritation and pay attention to local cleanliness.

Proliferative erythema complications Complications

1. Invasive squamous cell carcinoma: If the non-invasive proliferative erythema disease is not treated or treated improperly, the lesion may show infiltration, erosion, ulceration or papillary changes, which often indicates that it has developed into invasive squamous cell carcinoma.

2. Peripheral tissue invasion and lymph node metastasis once converted to invasive squamous cell carcinoma, can invade surrounding tissues, accompanied by regional lymph nodes and (or) distant metastases (about 20%).

Proliferative erythema symptoms common symptoms penile induration

1. Occurs in the glans or foreskin, but also in the labia, lips and mucous membranes at the junction with the skin.

2. The incision of the foreskin in the infancy does not occur in the penis, the disease is not limited to the elderly, the lesion of the penis appears in the glans, red under the foreskin, shiny, slightly uplifted, the boundary is obvious, the shape is irregular, typical Skin lesions have a lacquer-like appearance, often moist, bright or grainy appearance, soft texture, velvety-like, and thus can produce secretory molting or shallow ulcers.

3. The development of skin lesions is extremely slow. Skin lesions can spread from the mucosa to the skin. If induration, sickle lesions and ulcers occur, it can be considered as an invasive change, which can spread. The ulcer formation seems to be related to invasive squamous cell carcinoma. Ulcer and papillary proliferation can progress to spine cell carcinoma, invasive squamous cell carcinoma occurs in 10% of cases with primary lesions; if squamous cell carcinoma invades the submucosal layer of the penis, local lymph nodes and/or distant regions appear in 20% of cases Part transfer.

4. More than half of the patients have local itching and/or pain, and a few have bleeding.

Proliferative erythema

Histopathology: thickening of the stratum corneum, covered by secretory sputum or abnormal keratin, irregular thickening of epidermal cells, especially between the nipples of the margin, can form epidermal processes and extend into the dermis, thickening of the spinous layer is similar to Bowen's disease The spine cells are spindle and elliptical. The cells can have large and dense nuclei and multiple nuclei. Premature keratinization, polar disorder, increased mitosis and vacuolar cells, dermal capillaries, inflammatory Cell infiltration.

Diagnosis and differentiation of proliferative erythema

Most genital diseases of the glans or foreskin are rarely well defined and are effective with steroids and antibiotics. Tissue biopsies are useful for diagnosis.

Differential diagnosis

The disease needs to be differentiated from psoriasis, lichen planus, Bowen's disease, pseudoepithelial neoplasia, and keratoacanthoma.

1. Psoriasis and lichen planus occurs on the glans and psoriasis and lichen planus can be red plaque infiltration, but psoriasis has multiple layers of silvery white scales, and there is a sieve-like hemorrhage after stripping; lichen planus is produced in The glans are often ring-shaped with oral mucosal damage. In addition, psoriasis and lichen planus lesions can be seen in other parts of the body, and histopathology can be identified.

2. Bowen's disease It is difficult to distinguish between proliferative erythema and Bowen's disease. Some people think that this disease is a subtype of Bowen's disease. The difference is that Bowen's disease can be applied to all skins except the mucosa. The disease is limited to the mucosal or mucosal skin junction, with good prognosis, less malignant transformation and metastasis.

3. Pseudoepitheliomatous hyperplasia is caused by various causes such as chronic granuloma or ulcer. Histopathology shows that the epidermis has obvious hypertrophy and irregular proliferation, which can penetrate deep into the dermis, and most of the nucleus divides. Good, inflammatory cell infiltration can be seen around the hypertrophy of epidermal hypertrophy.

4. Keratoacanthoma (keratoacanthoma) is more common in the elderly, it occurs in the face, ear and back of the hand and other exposed parts, the skin lesions are usually a single pea to broad bean solitary hemispherical bulge, hard, clear boundary, The top can form a crater-like depression, fill the angle plug, grow rapidly, and leave atrophic scar after absorption.

Histopathology: epidermis proliferation is obvious, can invade the dermis, proliferating spine cells can see most nuclear division, dermal edema, lymphocytes, eosinophils, granulosa cells and a few plasma cells infiltration.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.