- Low-grade squamous cell carcinoma (SCC) in situ of the genitalia (although extragenital lesions have been reported)
- Induced by human HPV infection:
- Oncogenic genotypes (e.g., HPV 16, 18, and 31)
- Sexually transmitted condition
- Overall course of disease:
- Generally regresses spontaneously
- In rare cases, may transform into invasive SCC (< 1 %)
- The condition most often affects individuals in their 3rd to 5th decade of life (mean age: 31 years).
- Both sexes are affected, with slight male predominance.
- No racial predilection
- HPV infection (HPV 16 is the most common associated agent)
- Immunocompromised status
|Number and morphology||Multiple papules|
|Color||Red-brown to violaceous|
|Size||< 1 cm|
Diagnosis and Management
- Skin biopsy:
- Focal epidermal hyperplasia
- Partial-/full-thickness epidermal dysplasia
- HPV subtyping
- Evaluation of other sites: oral, genital, and anal areas
- Sexual-partner evaluation
- Conservative, with close follow-up
- Most cases regress in an average of 8 months.
- Persistent or cosmetically bothersome lesions can be treated with locally ablative therapies (e.g., cryotherapy, excision, or fluorouracil).
- Prevention: HPV vaccination
- Recurrence is common regardless of the treatment method.
- Squamous cell carcinoma (SCC): the 2nd most common skin cancer and usually presents as a firm, erythematous, keratotic plaque or papule. Diagnosis should be suspected on a clinical basis, and histopathologic examination confirms the diagnosis, with pathognomonic features such as keratin pearls.
- Genital warts (HPV): common sexually transmitted condition induced by HPV infection. Lesions present as exophytic cauliflower-like growths that can be seen on the penis, vulva, vagina, or cervix.
- Bowen disease: synonymous with SCC in situ of the skin and presents as a scaly, red, well-demarcated papule or plaque. Biopsy is necessary to confirm the diagnosis and rule out invasive carcinoma. Then the skin cancer should be definitively treated with excision or topical chemotherapy.
- Bolognia, JL, Schaffer, JV, Cerroni, L. (2018). Anogenital Disease. Dermatology, 4e. Edinburgh Elsevier.
- Lim, JL, Asgari, M. (2021). Cutaneous squamous cell carcinoma (cSCC): Clinical features and diagnosis. UpToDate. Retrieved April 20, 2021, from https://www.uptodate.com/contents/cutaneous-squamous-cell-carcinoma-cscc-clinical-features-and-diagnosis