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Image Number 327 (Pruritus Scroti)


Diagnosis: Pruritus Scroti

Site: Scrotum

Sex: M

Age: 40

Type: Clinical

Description: Excoriated lichenified plaques

Submitted by: Shahbaz Janjua

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Differential Diagnosis

History: Pruritus scroti which is considered as male counterpart to pruritus vulvae, may be caused by various inflammatory disorders, infections, infestations, and neoplasms. Acute pruritus is usually caused by infections or contact dermatitis whilw chronic pruritus may be the result of inflammatory dermatoses and malignancies. In idiopathic anogenital pruritus or neurodermatitis, the skin findings should be limited to lichenification and excoriations.  Laboratory evaluation, including bacterial and fungal cultures, microscopic examination, skin biopsies, and measurement of blood glucose levels, is useful in establishing the diagnosis. Management of pruritus scroti includes avoidance of irritants, allergens, and restrictive clothing and use of topical and systemic agents that provide both symptomatic relief and specific treatment of the underlying cause.  A short course of a high-potency topical steroid should bring moderate to complete relief. Sedating antihistamines may limit nocturnal symptoms. Antidepressants may be required in patients refractory to treatment or with underlying psychiatric disorders.

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