Global Dermatology Grand Rounds:
Case of the Month: May 1995
submitted by Dr. Rhett Drugge

September 1996



August 1996

June 1996

May 1996

April 1996

July 1995

June 1995

May 1995

February 1995

 January 1995

A 30 year old white male with a three year history of scrotal pruritis.


Click on the image for magnification

12 5-10 mm excoriated papules with surrounding lichenification and eczematization of the anterior scrotum. The initial diagnostic impression was lichen simplex chronicus.

The patient was treated with intralesionally triamcinalone acetonide suspension (5 mg in a volume of 1cc 1% Lidocaine with Epinephrine 1:100,000). He was much improved on follow-up one month later.

Physical exam revealed a 4x12 mm indurated cord of the medial scrotum which was draining at the distal end.This was noted to be a center of the inflammatory lesions first diagnosed as lichen simplex chronicus. Serosanguinous material was expressed.

LABORATORY: A biopsy was obtained which revealed pseudostratified columnar epithelium. He responded to treatment consisting of warm compresses and Zithromax with complete resolution of the eczematization and pruritis. The cord, while still present, was greatly reduced in size. Surgical intervention was not deemed necessary.

EMAIL your diagnosis to the Internet Dermatology Society .


Wright, S, Navarasha, H, Leigh, IM, Idiopathic scrotal calcinosis is idiopathic, J Am Acad Dermatol, May 1991;(24(5 Pt 1):727-30
Sadler, BT, Greenfield, SP, Wan J, Glick, PL, Intrascrotal epidermoid cyst with extension into the pelvis, J Urol, April 1995;153(4):1265-6
Terao, Y, Harnada, T, Median raphe cyst of the penis, Cutis, November 1984;34(5):495-6
Bode, U, Plewig, G, Classification of follicular cysts: epidermal cysts including Gunther sebocystomatosis, steatocystoma multiplex and trichilemmal cysts, Hautarzt, January 1980; 31(1):1-9
La Nasa, JA, Epidermal cyst of the median raphe, Urology, October 1976;8(4):401-2
Fishbein, AI, Problem of the etiology and pathenogenesis of neurodermatitis in the ano-genital region, Vestn Dermatol Veneral, July 1971;45(7):67-8E

EMAIL your diagnosis to the Internet Dermatology Society.

If you have a challenging case, please send relevant case materials to one of the following addresses:

If you mail in your case, please include the appropriate clinical and pathology slides to be scanned in.

Global Dermatology Grand Rounds
Rhett J. Drugge, M.D., Founding Editor
50 Glenbrook Road
Stamford, CT 06902 USA
Phone: (203) 324-5719

If you email your case, please include compressed jpeg or gif images to: rdrugge[AT_SIGN_HERE]

Thanks for your participation!