|
|
| ||
CASE HISTORY:
A 30 year old white male with a three year history of scrotal
pruritis.
|
PHYSICAL EXAMINATION: |
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 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]telemedicine.org.
Thanks
for your participation!
