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Have white patches on scrotum. Could it be due to scratching?

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General & Family Physician
Practicing since : 1986
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Hi, Since about the age of 14 I ve had a habit of scratching my scrotum , this is mostly after i play sport but also sometimes when the area is dry and not even that itchy. Im now in my early 30 s and I have white patchy areas on my scrotum below my penis . Im sure they are a result of years of habitual scratching. I doubt it a type of STD as I had never had sex before it started. there is also no pain at all unless I have scratched too hard, usually it gets itchy over the next few days but only as its recovering from where I have scratched. I also have found myself scratching there in my sleep, which is worrying as it can hurt when I wake up. Im 32 of good health. Any advice on this would be very much appreciated. thank you
Posted Mon, 3 Dec 2012 in Testicle Problems
Answered by Dr. Stephen Christensen 2 hours later
Hello. Welcome to Healthcare Magic. I'm Dr. Stephen Christensen.
Without an examination it won't be possible to diagnose your condition, but I can give you a couple of ideas as to what might be going on here, and you can see your doctor to confirm your diagnosis and discuss your options for treatment.
There are several skin disorders that could account for your symptoms. Two, lichen sclerosus and lichen planus, are relatively uncommon. The cause of these conditions is unknown, but they could be triggered by an ongoing immune response to an infection or allergen you were exposed to many years ago. Lichen sclerosus and lichen planus sometimes resolve on their own, but both conditions can persist. Both are associated with itching, and both can cause whitish patches or bumps around the genitals.
Another possibility here is psoriasis, which is a chronic skin disorder that is driven by a hyperactive immune response to unknown stimuli. This immune response leads to inflammation in discrete areas of the skin; itching, redness, thickening and whitish or silvery scaling are typical signs and symptoms of psoriasis.
All of these conditions typically respond to topical corticosteroids, and there are a variety of other treatments available, depending on the specific condition you have. Unfortunately, these skin diseases may require long-term (possibly lifelong) therapy.
I hope that helps. You'll need to see your own doctor for additional information and treatment, but I'll be available to answer any other questions you may have.
Good luck!
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Follow-up: Have white patches on scrotum. Could it be due to scratching? 46 minutes later
Thank you Doctor,
I've done some research on these and this is what I've understood
lichen sclerosus; although this looks most like what I have it seems to affect the end of the penis in men, with me its on the sides of the scrotum the penis is completely unaffected and all other areas of my body are fine. The other 2 look nothing like what I have. I think that the whitened areas I have are a result of scratching the area over a long time and not a direct result of the condition, is this possible?, although something is clearly causing my to scratch.
Also, sweat and heat, tight trousers make it itch. I have looked at jock itch but this seems to affect the scrotum to the inside of the leg, mine is directly on the sides of my scrotum and doesnt affect my legs at all.
I should have added that there are some very small white spots in that area also.

Thank you

Answered by Dr. Stephen Christensen 35 minutes later
It sounds more like lichen planus, given this additional information. When lichen planus occurs on the genitals, it often causes white spots, plaques and patches.
Tinea cruris, or jock itch, usually has a fairly distinctive appearance: broad areas of redness within the creases of the groin with flaking around well-demarcated edges. Another condition called erythrasma, which is caused by a superficial bacterial infection of the skin, is similar in many respects to jock itch but usually isn't as itchy. Your symptoms aren't really consistent with either of these disorders.
Skin disorders can be very difficult to diagnose, even when we can examine a patient directly. In some cases a biopsy is required to differentiate between similar-appearing conditions.
If you want to pursue the jock itch issue, this problem usually responds to over-the-counter antifungal creams, such as terbinafine or clotrimazole. If you haven't noticed significant improvement within a few days, I'd suggest a visit to your physician.
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