Deen Kristyn, Burdon-Jones David
Department of Dermatology, Mater Misericordiae Hospital, Brisbane, Queensland, Australia.
Australas J Dermatol. 2017 May;58(2):86-92. doi: 10.1111/ajd.12466. Epub 2016 Mar 8.
Penile intraepithelial neoplasia (PIN), or penile squamous cell carcinoma in situ, is a rare disease and may be associated with high morbidity and mortality. In an attempt to avoid surgical intervention, which may result in poor cosmetic and functional outcomes for patients, many non-invasive treatments have been trialled with variable success rates. This review summarises the available literature describing the use of topical imiquimod for PIN. While the results of our review are limited by the heterogeneity of the methods and follow ups of the included case series and case reports, they highlight the fact that patients with PIN have variable responses to imiquimod which seem less effective than previously reported. Therefore, if imiquimod treatment is instituted in PIN, clinicians should counsel their patients about the effects associated with treatment, the potential for a partial or no response to treatment, and the risk of recurrence. A strict follow-up plan is also necessary to monitor both patient adherence and PIN recurrence after treatment completion, in case surgical options need to be considered.
阴茎上皮内瘤变（PIN），即阴茎原位鳞状细胞癌，是一种罕见疾病，可能与高发病率和死亡率相关。为避免手术干预可能给患者带来不良的外观和功能结果，人们尝试了多种非侵入性治疗方法，成功率各不相同。本综述总结了描述外用咪喹莫特治疗PIN的现有文献。虽然我们的综述结果受到纳入的病例系列和病例报告的方法及随访异质性的限制，但这些结果凸显了PIN患者对咪喹莫特反应各异这一事实，且其效果似乎不如先前报道的那样好。因此，如果对PIN采用咪喹莫特治疗，临床医生应向患者告知与治疗相关的影响、治疗可能部分无效或完全无效的可能性以及复发风险。制定严格的随访计划对于监测患者治疗后的依从性和PIN复发情况也很有必要，以防需要考虑手术选择。
