Oyster-shaped hyperkeratotic plaques on the penis

A 26-year-old man presented with a one-week history of lesions on the glans penis. The patient also stated that he had recurrent episodes of genital warts, which had been electrocauterized on previous occasions. He denied trauma, medication and history of another skin disorder. Physical examination revealed remarkably thick and hard, hyperkeratotic, oyster-shaped scales adherent to multiple erythematous lesions on the glans penis. Hyperpigmented, clustered verrucous papules, which coalesced to form plaques, were also detected on the shaft of his penis (Figure 1). A shave biopsy from a hyperkeratotic lesion on the glans penis was performed; photomicrographs are presented in Figure 2A, B.