Abstract
Many male patients with genital disease have an underlying fear of genital cancer. A compassionate approach, accurate diagnosis and appropriate treatment and follow up are essential to minimising personal and relationship distress for patients with benign, premalignant or malignant lesions.
Key Points
- Accurate diagnosis of any hyperpigmented genital lesion is important as such lesions may raise concerns about genital melanoma.
- Genital melanotic macules need to be differentiated from melanoma.
- Genital dysaesthesia is an increasingly recognised disorder of male genitalia that often leads to marked distress.
- Genital seborrhoeic keratoses need to be differentiated from sexually acquired genital warts (condyloma acuminata) because a wrong diagnosis may lead to both significant personal and relationship distress.
- Penile intraepithelial neoplasia or in situ squamous cell carcinoma (SCC) is the most important premalignant male genital skin disease.
- Penile SCC is an uncommon cancer affecting mostly uncircumcised older men that is increasing in the developed world.

