Every now and then urologists are asked to give an opinion on genital lesions and rashes. This article from University College Hospital London is certainly worth a read. Most conditions are benign but some are precancerous leading to penile cancer with mortality and medico-legal aspects. In the article useful tables describe key points in the history and extragenital signs. A detailed description is given of lichen sclerosus and lichen planus along with indications for penile biopsy. Guidance is also given for when to refer cases to specialist centres. Alarmingly, genital lichen sclerosus is associated with 50% of cases of penile cancer and these cases should be identified earlier on.