Balanitis is an inflammatory condition of the glans penis that is most frequently associated with candidal infection when a n infectious etiology is found. Although balanitis is common, it is rarely associated with penile neoplasms. Pseudo-epitheliomatous keratotic and micaceous balanitis is a pathological and clinical description of an exceedingly rare condition. The initial report of Lortat-Jacob and Civatte suggested that pseudo-epitheliomatous keratotic and micaceous balanitis was benign, yet they subsequently described a malignant change in their patient.’ More recently others have also documented the development of penile neoplasms in patients with this condition.2.” We report the tenth case of pseudo-epitheliomatous keratotic and micaceous balanitis. epitheliomatous keratotic and micaceous balanitis is unknown, yet most patients are uncircumcised and older than 50 years. Furthermore, to our knowledge there have been no reports of lymph node involvement or metastases in these cases. The clinical differential diagnosis includes balanitis, balanitis xerotica obliterans, genital leukoplakia, lichen planus, kraurosis penis, scleroderma, penile horns, keratoacanthoma, giant condyloma, erythroplasia of Queyrat, Bowen’s disease and squamous cell carcinoma. Treatment of biopsy proved pseudo-epitheliomatous keratotic and micaceous balanitis should be determined by the severity of the disease. We agree with Krunic et a1 that