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Child suffered severe sunburn, rash in groin area. Genitals receded into body. Cause, how to rectify?

My step son is staying with us for the summer, he is 9. He went with his grandmother to the beach for the day and got a severe sunburn . Along with the sunburn pain he also complained to my wife and I about chafing related rash in his groin area. I went outside to water the grass and when I came back in my wife was hysterical. She told me that while I was outside he said the pain had become severe and she wanted to make sure he was okay. When she took him to the bathroom to see what was going on, what she saw was a shock. She described it as his genitals had completely receded up into his body. Where his penis should be, there was only a hole, and his testicles we no longer there and only loose skin remained. She described the whole area as being smooth and somewhat fat or swollen . Since he does not live with us it has been about 3 years since she has seen what was going on down there. We are very worried and not really sure what to do or who to talk to about the situation. Any advice would be appreciated.
Asked On : Tue, 10 Jul 2012
Answers:  1 Views:  94
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Pediatrician 's  Response
I would actually wonder if there might be several things going on here. Without seeing him it is difficult to answer with complete certainty. To discuss the retracting genitals first: Is your step son overweight? Sometimes overweight children will have what is called a "hidden penis." The penis is essentially buried beneath the extra weight in the lower abdomen and groin area. It may be that his penis has looked this way for a long time but if you haven't examined his penis and testicles for a while you might not have noticed. With respect to the testicles. There is something called a cremasteric reflex that pulls the testicles up when the inside of the thighs are brushed. If this happened just before looking at him it may be that all he needs to do is relax and wait a minute or two for them to go back to where they should be. Another trick is to have him sit cross legged in a warm bath and check to see if they are both in the scrotal sack at that point. Boys at 9 years of age will frequently know if they have their two "balls" where they should be. Never hurts to ask him. If both testicles are not down it is worth making an appointment with his pediatrician to have him examined.

With respect to the sunburn and chafing in the groin area. It is interesting. Again a couple of potential possibilities. The most obvious is that the groin perhaps was irritated by sand from the beach in the bathing suit causing a contact irritation. Often a bath and some thick cream or ointment applied to the area (with or without hydrocortisone - sometimes it stings if the kids are sensitive) can do wonders to remove the irritation and treat the pain. If the pain is severe then oral pain medication may be necessary. If it is particularly itchy then an oral antihistamine (diphenhydramine) can be helpful. If the sunburn itself is bothering him then oral pain control, topical aloe vera, and sometimes a steroid cream can be helpful for sunburn relief.

The other possibility I would not ignore is the possibility that he has a strep or staph infection. Certainly is he has fever (38 Celcius or above) and/or sore throat, this becomes even more likely. With the concentration of the "sunburn" in the groin which really shouldn't have been exposed to the sun (unless he was at the beach naked) I would be worried that the groin sunburn isn't a sunburn at all. If the area looks just like a patch of redness all over the groin then you might want to bring him in to see his pediatrician.

Also next time at the beach remember to reapply the sunscreen. Grandmas usually don't forget to have the children put the sunscreen on but often it is difficult to get them to put it on again, and again, and again throughout the day. The biggest mistake people make is not reapplying the cream. If you are sweating or swimming ideally you should be putting on more sunscreen every 30-60 minutes.
Answered: Sun, 17 Mar 2013
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