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Abstract: The patient presented to our hospital with an itchy, red rash and small bumps on the scrotum. Through understanding the patient’s situation, we learned that the patient had not engaged in high-risk sexual behavior, but had to be sedentary on a daily basis due to work or habits. The initial diagnosis of eczema of the scrotum was made through the results of relevant tests and the patient’s symptoms. After 4 weeks of symptomatic medication, the patient’s symptoms have been cleared and there is no sign of recurrence after review.
Basic information】Male, 24 years old
Type of disease】Genital dermatitis (scrotal eczema)
Hospital】Eastern War Zone General Hospital
Date of consultation】August 2021
Treatment plan] Topical medication (Loratadine tablets, Denide cream, Tacrolimus cream)
Treatment Period】4 weeks, regular follow-ups
Effectiveness of treatment】Rash disappeared, no sign of recurrence
I. Initial consultation
When the patient came to our hospital, she complained that she felt itching on her vulva skin some time ago. At first, she did not care about it because it did not affect her life and work, but recently she found that her vulva skin became red and had small bumps, accompanied by increased itching. As she was worried about her health, she rushed to the hospital for consultation. I asked the patient carefully about his condition and learned that he did not have bad sexual behavior and had never been to public bathrooms, but because of his work and lifestyle habits, he had sedentary habits and little exercise on a daily basis. The patient was given a physical examination, which showed that there were red papules at the scrotum and part of the scrotal skin was broken because the patient often scratched.
II. Treatment history
Since vulvar diseases are usually combined with fungal infections, the patient was given fungal microscopy and culture upon admission, and the results were negative, suggesting that the patient was not combined with fungal infections. The patient was then given anti-allergy treatment, including oral loratadine tablets and topical corticosteroid ointment, such as Denide cream. After 2 weeks of treatment, the patient’s red rash and other symptoms were relieved significantly, but because there was still mild itching and other discomfort, the patient was given topical ointment adjusted to tacrolimus cream, and after 2 weeks of continued treatment, the patient’s symptoms, itching and other symptoms had disappeared.
III. Treatment effect
After 2 weeks of symptomatic medication, the patient’s scrotal flushing and itching, as well as the appearance of small bumps, were significantly improved compared to the symptoms that appeared before the visit. After 2 weeks of continued treatment, the flushing and itching of the entire scrotum basically disappeared, and the patient was then instructed to have regular outpatient follow-up. So far, the patient has been followed up for six months, and his symptoms have cleared up, while no signs of recurrence have been found for the time being.
IV. Notes
I feel very relieved to see the patient’s symptoms gradually reduced, but still need to remind the patient to pay attention to some matters in daily life: 1.
1, daily attention to choose loose, comfortable underwear, avoid tight underwear to reduce the friction on the scrotum. Patients are advised to avoid being sedentary on a daily basis and can engage in moderate activities at intervals.
2. Change and wash underwear regularly, especially after sweating, and also rinse off the soap and laundry detergent residue on the underwear after washing to avoid irritation to the scrotal skin.
3. In terms of diet, it is recommended to eat mainly vegetarian food, try to eat more fresh vegetables and fruits, and avoid stimulating foods such as chili, wine, onion, etc., as well as seafood such as crabs and lobsters to avoid aggravating the condition.
V. Personal insight
Eczema is a relatively common clinical skin disease, usually occurring in any part of the patient, such as the case of the patient in this case, is the scrotum area eczema. Because the scrotal area of the skin is special and sensitive, and poor tolerance to external stimuli, and the patient needs to sit for a long time because of work, so that the scrotum for a long time in the stuffy, hot and other environments will be prone to develop. This shows that if a patient with scrotal eczema comes to the clinic, we, as doctors, should give priority to health education so that patients can clearly understand the causes of eczema, and at the same time clarify what they can pay attention to in their daily lives to avoid eczema, or help their recovery, which can also greatly reduce the recurrence of patients.