Prevention has centered on improved hygiene of the prepuce. Although circumcision has been advocated for refractory or recurrent cases, this is now primarily used if improved drying and hygiene are not effective. The outcome is often favorable, with treatment failures often leading to further clinical examination and tailoring of the treatment to the particular offending agent. Failure of response in the setting of appropriate treatment should raise the suspicion of malignancy. This necessitates a biopsy to rule out both primary malignancies and secondary malignancies involving the penis. The most common malignancy that mimics balanoposthitis is erythroplasia of Queyrat,