Premalignant penile lesions are a spectrum of diseases ranging from those that are almost always benign to neoplasms that are carcinoma in situ. Balanitis xerotica obliterans is a localized variant of lichen sclerosus et atrophicus. The Buschke-Löwenstein tumor is a low-grade malignancy, whereas erythroplasia of Queyrat is a carcinoma in situ. Obtaining the correct diagnosis may challenge even the skilled clinician. It is increasingly likely that papillomaviruses play a role in the development of some cases of penile carcinoma. Scrotal cancer has both historical and current significance as an indicator of occupational health. Occasionally, extramammary Paget's disease presents as a primary scrotal neoplasm.
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