The unusual finding of posthitis xerotica obliterans occurred in a 12-year-old boy. The foreskin was thick and edematous and had a gray-tan inferior surface. Association with chronic balanoposthitis is probable since the prepuce had been irretractable for several years. There was no glans involvement or lesions of lichen sclerosus et atrophicus elsewhere. Circumcision is curative for involvement of the foreskin. In the adult, although surgical excision of the glans involvement when feasible is the treatment of choice, intralesional and sublesional injection of corticosteroids as well as highly potent corticosteroids applied topically with occlusive dressings often give satisfactory results.