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May 1995

Painful Ulcers of the Scrotum

Author Affiliations

The Ohio State University, Columbus (Drs Bigler and Flint), and Medical College of Georgia, Augusta (Dr Davis)

Arch Dermatol. 1995;131(5):609-610. doi:10.1001/archderm.1995.01690170111018

REPORT OF A CASE  A 22-year-old man was referred to us for swelling and painful ulcers of the scrotum associated with fever, nausea, vomiting, diarrhea, and groin pain. The scrotal lesions began as vesicles and pustules that eventuated in painful ulcers within 48 hours. He had been treated for condyloma acuminatum but denied a history of any other sexually transmitted disease. His general health was good, and he had not been taking any medications.Physical examination revealed a temperature of 39.5†C, slight inguinal adenopathy, and several ulcerations in the setting of an edematous, erythematous scrotum. The ulcers were separate and distinct, and all were exquisitely tender with a necrotic base (Figure 1). Some of the ulcers were characterized by a cribriform base (Figure 2). Lesions were not observed on nonscrotal skin.Histopathologic sections showed ulceration, under which was a deep, dense-diffuse mixed inflammatory cell infiltrate in which neutrophils were abundant.

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