Penile precancers are skin lesions manifested by papulo-tumorous proliferations on the skin and mucous membranes. Premalignant penile lesions can be difficult to distinguish from other benign dermatoses and have an uncertain natural prognosis. The most common cause of their appearance is a viral infection of the genitals caused by the human papilloma virus (HPV). It is estimated that 10-30% of people carry this virus, but in most cases the infection is subclinical. Other less common prerequisites for the development of precancers include phimosis, promiscuity and poor hygiene in the intimate area. These lesions are called a pre-cancerous condition, because changes in their cellular composition are actually observed, which, however, do not yet have characteristics of cancer. Malignant (malignant) transformation of penile precancers is observed in about 30% of cases. Premalignant penile lesions can be broadly divided into those associated with HPV infection and those unrelated but caused by chronic inflammation. Human papillomavirus-associated lesions include Bowen’s disease, Queyrat’s erythroplasia, and bonevoid papulosis. In the latter variants, carriage of the high-risk strains HPV types 16 and 18 is found. The low-risk HPV types 6 and 11 are associated with other premalignant lesions, such as giant acuminate condylomas (condyloma acuminata) or Buschke-Lowenstein tumors. Lesions not associated with human papillomavirus are primarily associated with genital lichen sclerosus et atrophicus and leukoplakia. Their genesis is also associated with rarer chronic inflammatory conditions such as balanitis herotica obliterans (xerotic obliterating balanitis). Carcinoma in situ of the penis includes the group of precancers that are associated with HPV and in 10 to 30% of cases progress to penile squamous cell carcinoma. Its variants are erythroplasia of Queyrat, in which a single papule of bright red color develops, located in the area of ??the foreskin or glans of the penis. The same lesion, however, in the area of ??the skin of the penis is found in Bowen’s disease. Bonevoid papulosis is an active infection of the genitals with HPV types 16 and 18. The lesions are multiple papules of red or purple color that are located on the body of the penis. Acute condylomas of the penis (condyloma acuminata) are dermatoviruses caused by HPV types 6 and 11. They are often multiple and cover a large part of the penis, and can also enter the distal part of the urethra. Lesions that are not associated with human papillomavirus most often occur as chronic inflammatory diseases of the genital system. Balanitis xerotica obliterans is a chronic dermatosis, a variant of Lichen sclerosus and atrophicans, usually found in the area of ??the glans penis or foreskin. It is a white atrophic plaque and is an extremely common condition in diabetics. Leukoplakia is a disease thatmanifested by single or multiple white plaques on the genital or oral mucosa. Treatment for patients with penile precancer involves many options. First of all, a virological test should be performed to type a possible HPV causative agent. Biopsy materials subjected to DNA analysis in specialized laboratories for molecular virology are used. Topical chemotherapy with 5% 5-fluorouracil (5-FU) is the most commonly used first-line treatment. It is most effective in immunocompetent patients with well-defined single lesions and has poor efficacy in immunosuppressed patients or those with multiple lesions. It is used in the treatment of patients with carcinoma in situ and bonevoid polyposis. Cryotherapy uses liquid nitrogen or nitrous oxide to generate rapid freeze/slow thaw cycles to achieve temperatures between -20�C and -50�C. The goal is to cause tissue damage through the formation of ice crystals, leading to disruption of cell membranes and cell death. All premalignant lesions are suitable for treatment by surgical excision. Primary surgical excision is recommended in patients who have extensive areas of involvement and in those who are unlikely or unwilling to adhere to strict conservative treatment. Surgical removal, on the other hand, offers a definitive solution to the problem, which is relevant to the subsequent possible recurrences of the disease. References: 1. National library of medicine-Diagnosis and management of premalignant penile lesions; 2. Urology-prof. P. Panchev.which is relevant to the subsequent possible relapses of the disease. References: 1. National library of medicine-Diagnosis and management of premalignant penile lesions; 2. Urology-prof. P. Panchev.which is relevant to the subsequent possible relapses of the disease. References: 1. National library of medicine-Diagnosis and management of premalignant penile lesions; 2. Urology-prof. P. Panchev.