Erythroplasia Keira: causes, symptoms, diagnosis, treatment

Erythroplasia of Keira (syn: epithelioma velvetica, epithelioma velvety) - cancer in situ, in comparison with Bowen's disease, he often metastases, which may be connected with localization features. Appears on the head of the penis, female genitalia, in the perianal region or (rarely) on the mucosa of the oral cavity. Oncogenic human papillomavirus type 16 or 33 is detected in 70% of cases.

Causes and pathogenesis of erythroplasia. Erythroplasia Keira is considered as an intra-epidermal cancer and belongs to the carcinoma group in situ. In the development of the disease, non-observance of personal hygiene is of great importance. Many dermatologists believe that Keira's erythroplasia is a variant of Bowen's mucous and semilucid diseases.

Symptoms of erythroplasia Keira. Erythroplasia Keira occurs significantly more often in men, usually older than 50 years, not subjected to circumcision. In most cases, a single, slightly edematic lesion appears on the genitalia (in men - the glans penis, foreskin, in women - the vulva region), which has sharply outlined uneven borders, round or oval shape. There are slight infiltration in the hearth and soreness. Its surface is characterized by a rich red color, often with a brownish hue, moist, shiny, glossy, as if velvety. Over time, there is an increase in infiltration, sometimes erosion of the outbreak. In case of secondary infection, a purulent discharge is noted, and the focus is covered with a yellowish coating.

The focus is usually single, sharply outlined, oval or round, often with scalloped edges. The surface of its rich red color, with a brown tint, moist, shiny, velvety. As the process develops, infiltration becomes more pronounced, the surface can become crusted, bleeds easily, sometimes becomes vegetative, eroded, which can serve as a sign of the development of infestation.

Localization of erythroplasia of Keira and other parts of the skin and mucous membranes is described. The disease is most often transformed into squamous cell carcinoma.

Histopathology. The changes are similar to the histological pattern in Bowen's disease. Uneven acanthosis, focal hyper- and parakeratosis are observed. As a result of the violation of cell differentiation, atypical cells appear. In the dermis, an infiltrate is noted, consisting mainly of lymphocytes and a small number of plasma cells.

Pathomorphology. In the entire thickness of the epidermis, small, misplaced, interconnected cords of atypical cells are identified. Unlike the classic picture of Bowen's disease, there is no dyskeratosis. The rest of the histological pattern corresponds to a basaloid-bouonoid type of proliferation of epidermal strands.

Differential diagnosis. Differentiate the keryl erythroplasia from balanoposthitis (vulvitis), kraurosis, plasmocellular limited balanoposthitis Zoon, limited psoriasis, eczema, fixed erythema, red flat lichen, spinalomy, pagetoid epithelioma, Paget's disease, syphilis. Kair's erythroplasia is also differentiated from Bovenoid papulosis, the genital form of the red flat lichen, fixed drug erythema, limited Zoon plasmocellular balanitis, in which the epithelium is usually thinned, and the dermis contains a dense inflammatory infiltrate with a large number of plasmocytes. Capillaries are usually dilated, deposits of hemosiderin may appear. Atypical growths of the epithelium are not detected. In view of the large clinical similarity of these diseases, the final diagnosis is made on the basis of histological examination data.

Treatment of erythroplasia Keira. Assign bleomitsin, radiation treatment, surgical excision and external - cytostatic ointments.

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