Introduction. Keratotic lesions are a common encounter in the genital area in the practice of gynecologists or dermatologists. Making a precise diagnosis can be challenging, but it is critical for treatment and prognosis. In these instances, a dermoscopic examination is particularly useful because it is a quick, inexpensive, noninvasive and sensitive examination. However, dermoscopic data comparing bowenoid papulosis (BP), seborrheic keratosis (SK) and condyloma acuminatum (CA) is still lacking. More than 40 different genotypes of HPV infect the vaginal area and cause diverse intraepithelial neoplasms. Materials and method. We propose to exemplify the differences of the three diagnostics – BP, genital SK and CA – by describing their dermatoscopic characteristics and the relation with the HPV infection. Results. Dermoscopic findidings: BP has glomerular vessels, CA has hairpin vessels, and SK has the smallest vascular pattern. The SK has a cerebriform look, while the CA has a knob-like or finger-like shape with a whitish halo. HPV DNA detection is positive in both BP and CA, while studies suggest that more than half of SK have positive HPV findings. BP has the highest detection rate for high-risk genotypes, mostly HPV 16, and CA has the highest detection rate for low-risk genotypes, primarily HPV 6 and HPV-11. Conclusions. Before resorting to an invasive procedure, dermoscopy can help distinguish the entity of genital keratotic lesions, and a physician should examine the morphologic plasticity of HPVrelated keratosis in the genital area or the genital wart in the enlarged notion. [ABSTRACT FROM AUTHOR]