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Scrotal Ulceration
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Scrotal Ulceration

Hi all,

I am 19 years of age and for the past year I have been suffering from sudden onsets of scrotal ulceration, which almost always result in surgical debridement of the area affected. Since December 2010, I have been operated on three times to remove the affected skin.

In early December 2010, I had my tonsils removed, following frequent bouts of tonsillitis. It was shortly after this operation, having been bedridden and doped up on painkillers for a week or so, that I noticed 3 patches of inflamed skin, on the left, right, and bottom of my scrotum. This was accompanied by extreme pain, and after seeing the doctor, I was sent to hospital where the skin was removed.

During my recuperation in hospital, the docs said that the top of my left lung had collapsed slightly due to the presence of pneumonia. I was promptly treated for this, and within a week, my lung was looking healthy again.

Having been discharged at the end of the month, things continued healing until March 2011, when I was readmitted following acute ulceration of the wound area, with a watery yellow discharge. This was treated with iodine to the area itself, which seemed to dry the ulcers up, along with intravenous antibiotics.

A number of months passed with minor ulcers appearing on the wound occasionally. Dressing the wound daily with gauze and softpore adhesive surgical dressings was enough to give me the comfort I needed to continue with daily life. It was only a couple of months after the wound had healed completely, (mid September 2011) that I started to feel ill with what I thought was just a regular cold. About 3 Ulcers appeared on the scrotum as they had done before, and I wasn't initially worried. However, within 24 hours, a couple of the ulcers started to develop a purplish-black ring around them, with acute pain accompanying.

I immediately went to the hospital that had dealt with me beforehand, where they took a look and didn't seem incredibly fussed, despite me telling them my track record. They gave me a course of antibiotics, and sent me on my way. I returned less than 12 hours later, due to the speed at which the ulcers had progressed. They were now at least double the size that they had been. However, they still did not want to take any further action. It was only when I returned again, in a considerable amount of pain with symptoms mirroring the original incident, that they took me seriously and decided to operate to remove the skin again. I was admitted to hospital and had the wound monitored and cleaned for the next 8 days.

Following these events, I had no occurrences of ulceration on the scrotum, and bar a cold or two, I felt healthy. I have been dressing the wound daily. It's only now, after a weekend away with some friends, (aka drinking a lot of alcohol and sleeping on the floor) that I have started to feel under the weather and notice some slight ulceration. It would seem the ulceration is related to me feeling under the weather.

Apologies for this absolute novel of a question. This condition has caused me to lose jobs, miss out on numerous family occasions, as well as cause a large amount of physical and emotional upset.

If there's anyone out there with so much as an inkling of a clue as to what could be causing this, please do not hesitate to share your thoughts and ideas.

Thanks in advance.
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3 Comments Post a Comment
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Avatar_dr_f_tn
Hi,
How are you? Are there other symptoms present? What other diagnostic tests were done in the past? Recurrent scrotal ulcerations may be due to skin conditions as well as infection that is possibly resistant to some antibiotics. You may benefit from further evaluation by a dermatologist as well as additional tests including blood and std panel tests. Take care and do keep us posted.
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995833_tn?1375604252
Incomplete Behcet's disease possibly. 'Pathergy test' would clinch diagnosis.
Best wishes.
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Avatar_m_tn
Thank you both for your replies. I feel well in myself at the moment, though I have had a couple of ulcers at the back of my throat for the last 8 days or so, as well as a tender feeling around the scrotal wound. These have both been improving since, and I feel completely healthy apart from the occassional mild pain from the ulcers in the throat.

I did have a lot of blood tests in hospital, as well as swabs of the affected area before it was removed. The results didn't show much, apart from a severe amount of inflammation in the skin affected. I was given flucloxacillin and metronidazole when symptoms first arose, but this was not enough to stop the illness progressing. I was also tested for HIV/aids, and these tests came back negative.

I was referred to a Urologist as well as a Dermatologist, and there was some speculation at Behcet's disease, however, due to a lack of other symptoms usually present in Behcet's disease patients, a complete diagnosis couldn't be made.

I do get ulcers of the soft palate, which appear to be concurrent with the ulcers on the scrotum. They usually appear around the scar tissue left from the tonsillectomy. Perhaps the weakness of the scar tissue on the scrotum and the bed of the used-to-be tonsils has something to do with recurrence?

The doctors do seem to be baffled by these series of events. I am seeing a Urologist again next week for assessment of the area, and hopefully a haemotologist at some point. ( I've been referred, but am still waiting on a response)

When at it's worst stage, the skin appears gangrenous in nature, and exudes blood as well as a yellowish, watery liquid. Since it's first occurrence, it seems to have come back milder each time.

Again, thank you for taking the time to read my post and for offering your advice.
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