Suggest Treatment For Scrotal Itching
 
 
                                    
                                    
                                          
                                               Posted on
                                          
                                            
                                         
                                           Wed, 10 Sep 2014
                                           
                                        
                                        
                                        
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                                             Wed, 10 Sep 2014
                                                
                                            
                                                Answered on
                                                
                                                Wed, 10 Sep 2014
                                                
                                            
                                                Answered on
                                             
                                             Sat, 4 Oct 2014
                                                
                                                
                                                Last reviewed on
                                                
                                                Sat, 4 Oct 2014
                                                
                                                
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                                            Question : Dear sir,
I am having scrotal itching.
                            I am having scrotal itching.
                                    Brief Answer:
Pictures requested
Detailed Answer:
Hello XXXXXXX
Thank you for posting on HCM and I can understand your concern regarding the skin condition.
Itching over scrotum can be attributed to numerous conditions like infections
(Fungal, Bacterial) or mite infestation (Scabies) or due a eczematous condition called lichen simplex chronicus (LSC).
It is difficult to point specific diagnosis in absence of clinical examination. Thus, I would insist you to post some good clinical pictures so that I can guide you in a better way. You can mail pictures to YYYY@YYYY with the subject titlled 'ATTN Dr Hardik Pitroda'
Once I will review the pictures I will revert with the proper management plan for you.
Thanks
Dr Hardik Pitroda
                                    
                            Pictures requested
Detailed Answer:
Hello XXXXXXX
Thank you for posting on HCM and I can understand your concern regarding the skin condition.
Itching over scrotum can be attributed to numerous conditions like infections
(Fungal, Bacterial) or mite infestation (Scabies) or due a eczematous condition called lichen simplex chronicus (LSC).
It is difficult to point specific diagnosis in absence of clinical examination. Thus, I would insist you to post some good clinical pictures so that I can guide you in a better way. You can mail pictures to YYYY@YYYY with the subject titlled 'ATTN Dr Hardik Pitroda'
Once I will review the pictures I will revert with the proper management plan for you.
Thanks
Dr Hardik Pitroda
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Chakravarthy Mazumdar
                                  
                              
                                          
 
                                    
                                    
                                 
 
                                    Thank you so much for your information . as per your discussion over mail I have attached a pic upload in portal & also sending picture through mail. 
so please suggest me in a better way . because i am having this diseases from last 3 years . and I used 4-5 different medicine but result is zero .
                            so please suggest me in a better way . because i am having this diseases from last 3 years . and I used 4-5 different medicine but result is zero .
                                    Brief Answer:
Topical hydrocortisone
Detailed Answer:
Hie,
Thanks for the pics.
Its clear you have got thickening of scrotal skin suggestive of lichen simplex chronicus, a type of highly itchy eczema.
The treatment is challenging as its a chronic condition.
I would suggest you following treatment plan :
Avoid any further use of Cosvate cream as it contains very potent steroid Clobetasol which is not suitable for use over sensitive areas like scrotum.
Take oral low lose betamethasone 1mg once daily for 15-20 days
Apply a very mild corticosteroid like Hydrocortisone cream and a cream containing immunomodular
Pimecrolimus (PICON Cream) twice a day.
Sprinkle some dusting powder like Candid powder over it especially before going outdoor to absorb excess perspiration.
Take oral antihistaminics like levocetrizine as required.
Additionally, I would like to prescribe you oral gabapentine 300mg twice a day as it will reduce the itching due to hypersensitive nerve fibres.
Use a gentle soap like Cetaphil Bar on regular basis.
Avoid tight undergarments and if possible use cotton based loose boxers and that too after ironing them.
Please do update me about your condition after 3 weeks.
I
                                    
                            Topical hydrocortisone
Detailed Answer:
Hie,
Thanks for the pics.
Its clear you have got thickening of scrotal skin suggestive of lichen simplex chronicus, a type of highly itchy eczema.
The treatment is challenging as its a chronic condition.
I would suggest you following treatment plan :
Avoid any further use of Cosvate cream as it contains very potent steroid Clobetasol which is not suitable for use over sensitive areas like scrotum.
Take oral low lose betamethasone 1mg once daily for 15-20 days
Apply a very mild corticosteroid like Hydrocortisone cream and a cream containing immunomodular
Pimecrolimus (PICON Cream) twice a day.
Sprinkle some dusting powder like Candid powder over it especially before going outdoor to absorb excess perspiration.
Take oral antihistaminics like levocetrizine as required.
Additionally, I would like to prescribe you oral gabapentine 300mg twice a day as it will reduce the itching due to hypersensitive nerve fibres.
Use a gentle soap like Cetaphil Bar on regular basis.
Avoid tight undergarments and if possible use cotton based loose boxers and that too after ironing them.
Please do update me about your condition after 3 weeks.
I
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Chakravarthy Mazumdar
                                  
                              
                                          
 
                                    
                                    
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