Penile Intraepithelial Neoplasia: Successful Treatment with Topical 5% Imiquimod Cream

The authors present a case of a 36-year-old man with a penile intraepithelial neoplasia who was evaluated at the Outpatient Clinic of the Department of Dermatovenereology Diseases of the Clinical Center of Vojvodina in December of 2010. The patient was referred to this facility by an urologist and had histopathological reports of 4 biopsy specimens taken from different plaques on the glans penis. Biopsy samples were collected from lesions which were clinically diagnosed as leukoplakia. Histopathological findings of all biopsy specimens showed: “dysplasio epithelii planocellularis gradus levioris et partim gradus mediocris diffusa”. Given the histopathological diagnosis, the patient was referred to a dermatologist for conservative therapy of these lesions, avoiding radical surgery. On admission, the patient presented with slightly indurated erythematous plaques with some desquamation at the surface, and a tendency for diffuse involvement of the entire glans penis. Topical 5% imiquimod cream was administered on the lesions once a day and was washed off after 8 hours during 10 weeks. Check-ups were scheduled for every other week in order to assess the course and progress of topical treatment. No significant side effects were recorded, except for acute local inflammation accompanied by mild exudation and itching. After 10 weeks of treatment, complete regression of lesions was achieved, and in the following period of 18 months (until present) no recurrence was observed.