Bowen's disease, also known as squamous cell carcinoma in situ of the penis, is considered a premalignant lesion. It represents the earliest, non-invasive stage of squamous cell skin cancer, where the malignant cells are confined to the epidermis (the outermost layer of the skin) and have not yet invaded into the deeper dermal tissue. Clinically, it appears as a solitary, slow-growing, reddish-brown, scaly plaque or patch, often on the shaft of the penis. It is strongly associated with infection by high-risk strains of human papillomavirus (HPV), particularly types 16 and 18, as well as with chronic inflammation and immunosuppression. If left untreated, Bowen's disease has the potential to progress to invasive squamous cell carcinoma over time. Treatment is therefore recommended and usually involves local destruction or surgical excision to prevent malignant progression. Other penile lesions like condyloma acuminata (genital warts) are benign, though some are caused by low-risk HPV.

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