Intra-epitheliale neoplasie graad-III van de glans penis

A 56-year old man presented with a high risk HPV positive intraepithelial neoplasia grade III (PIN grade - III) of the glans penis. The patient was treated with imiquimod (3 times a week for 8 weeks) with normalization of the histologic pattern and the absence of high risk HPV. Two years later a mild flare up (PIN-I, hr HPV absent) was treated again with imiquimod, this time in combination with ablative lasertherapy (CO2). PIN - III encompasses the premalignant clinical entities erythroplasia of Queyrat and Bowen's disease, which both are mostly seen from the age of 50 and up and both are high risk HPV (16,18, 31, a.o) associated. Lifelong follow-up with all patient with PIN - III is essential to ensure early detection of recurrence and the possibility of malignancy.