Penile carcinoma is most likely to occur in which setting and is often associated with which infection?

• A. It often occurs in areas of irritation such as the foreskin
• B. It is typically caused by bacterial infection
• C. It presents with watery pus discharge
• D. It is never associated with HPV

Answer: (C)

Penile carcinoma tends to develop in skin areas subjected to chronic irritation and inflammation, such as the foreskin in uncircumcised men who have balanitis or phimosis. A major factor in its cause is infection with oncogenic human papillomavirus, especially HPV types 16 and 18, which can drive malignant transformation of squamous cells in the penile epithelium. Clinically, it usually presents as a persistent lesion or mass on the glans or foreskin that may ulcerate or become indurated; discharge like watery pus is not a typical feature. So the setting is irritated penile skin, and the infection commonly associated is HPV.