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| LETTER TO EDITOR |
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| Year : 1999 | Volume
: 65
| Issue : 1 | Page : 49-50 |
Dry, scaly dermatitis of scrotum
Correspondence Address:
How to cite this article:
. Dry, scaly dermatitis of scrotum. Indian J Dermatol Venereol Leprol 1999;65:49-50 |
| To the Editor | |  |
We often see patients having pruritic scaly dermatoses of scrotum. Scrotal skin becomes dry with dirty brown scales. Lesion often has mild serosanguinous discharge which soon dries up to form brown crusts. Whole area becomes erythematous and sometimes telangiectasia may be seen. Patients are adult males concerned by intense itching and often burning sensation of scrotum, particularly at bed time. They suffer for months or years together with relapse and remission. Area involved is diffuse often spreading to the undersurface of penis upto prepucial margin. Scales are loosely attached, some seem to enjoy picking of scales. Patients are commonly seen to be under stress and may be depressed.
In a minority of patients seborrhoeic dermatitis involving classical areas are seen, who readily respond to topical hydrocortisone, while in a few patients oro-oculogenital syndrome is a feature due to riboflavin and/or zinc deficiency.[1] Riboflavin and other vitamin B complex deficiency occasionally produce scrotal dermatitis, perleche, sore lips, tongue, and mouth.[2]
In differential diagnosis, lichen simplex chronicus has a well-defined margin. Diffuseness of the lesion and lack of involvement of other areas of the body excludes psoriasis. Sparing of the groins and negative fungal scraping excludes dermatophytosis.
Regarding treatment, topical corticosteroid in ointment base gives temporary relief of symptoms but often invites secondary fungal infection. In cases of riboflavin
deficiency 5-15mg. riboflavin two times daily for two weeks is curative. Simple emollients make skin moist, reduce intensity of itching. Tricyclic antidepressant doxepin 25-50mg. per day helps some patients. Anxiolytic alprazolam or antipsychotic thioridazine is helpful in some. Systemic or topical therapy has to be given intermittently for a long time.
| References | | |
| 1. | Goldsmith G A. In: Beaton GH, Mc Herry EW, eds. Nutrition vol.2. New York; Academic Press, 1994.  |
| 2. | Rook A, Wilkinson DS, Ebling FJG, et al, eds. Textbook of Dermatology, 5th Edn, Blackwell Scientific Publications, Oxford 1992;2364. |
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