Ingenol Mebutate therapy in Erythroplasia of Queyrat: a new approach

Background Erythroplasia of Queyrat (EQ) is a rare squamous cell carcinoma in situ, usually occurring on the glans penis, the prepuce, or the urethral meatus. Therapy is mandatory because it can progress to invasive carcinoma in up to 30% of cases. Treatment options include 5- fluorouracil, curettage, cryotherapy, radiotherapy, laser, partial or total penectomy, and micro surgery, as also with imiquimod and photodynamic therapies. Methods Between 2015 to 2018 we treated five patients, with histologically confirmed EQ, with ingenol mebutate (IM) 0.015% gel applied for 3 days consecutively. Results Three patients showed complete response at one year follow up. Two patients showed partial response after two months so they received a second course of therapy with IM. At one year follow up, one of them showed complete response, the other partial response. Conclusions Our experience demonstrated that IM may be considered as an effective and safe treatment option in EQ. IM offers various advantages such as easy and fast application, rapid complete remission, better compliance, few side effects and excellent cosmetical results. The authors call for further exploitation in bigger trials.