A 55-year-old man presented with an asymptomatic lesion adjacent to the urethral meatus of one year's duration (Fig. 1). His medical history was significant for quiescent lung sarcoidosis (treatment never required), asthma and irritable bowel syndrome. His only medication was a budesonide/formoterol inhaler. The plaque had slowly been increasing in size, had not ulcerated or bled and had not impacted sexual or urinary function. Examination did not reveal extension into the urethra. Biopsy revealed undifferentiated penile intraepithelial neoplasia (PeIN) III/carcinoma in situ.
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