Brief Answer:
Scrotal dermatitis with multiple epithelioid cysts

Detailed Answer:
Hi XXXXXX,

You said.. 1)you have severe itching on scrotum
2)scrotal skin and root of penis is reddish..i.e. Erythematous
3)you have small multiple cystic lesions those contain whitish cheesy
material

I have seen the photo you posted. I can see small cystic lesions.

With this much history and seeing image, I feel that most probably you suffer from scrotal dermatitis and multiple epithelioid cysts.

Scrotal dermatitis may of various origins..
1) lichen simplex chronicus
2) irrtant contact dermatitis
3) allergic contact dermatitis
4) seborrheic dermatitis
5) atopic dermatitis

I usually advise in my patients having problem as you have in following ways..

1) DM,HIV,Anaemia and other internal diseases should be ruled out after various investigations.

2) Psychlogical status shouls be evaluated to rue out anxiety,depression or other psychlogic problem ...this may precipitate lichen simplex chronicus.

3) If it is sudden in onset..likely to be acute irritant contact dermatitis. Suspected irritants like soap,pollutants,deodorants,powder,clothes,perspiration etc..should be considered.

4) If it is chronic in origin, allergic contact dermatitis should be considered. The allergens may be there..like soap,clothes,water,deodorants..etc

5) if there are intertrigo (dermatitic changes in fold area),dandruff,seborrhoea etc are found, then it may be seborrheic dermatitis

6) --Steroid like methyle prednesolone may be taken in tappering dose for few weeks
--Antihistahistaminic like levocetirizine may be taken till itch is relieved.
--Short course of antibiotics may be taken.
--Apply combined cream of steroid and antibiotics may be applied.
--Cleanse the area with dettol diluted in water. You may take Sitz bath in dettol water in tub.
-- For the prescription, you consult dermatologist.

7) for the cysts..I advise to remove them by the method of electrocautery under local anaesthesia done by dermatologist. Never squeez the cysts as that may lead
to secondary bacterial infection.

I hope this answer would be helpful to you. Still any query, you are welcome.

Wishing you early recovery.

Thanks.

Dr. Ilyas Patel MD

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