Dear Doctor

Please find the attachment of the mole or wart on my left testicle. I am quite worried about it. Can you please suggest what it is?

Dear Patient

The swelling on your scrotum looks like an epidermoid cyst. These are treated by removing them surgically.

Scrotum Skin Swellings

Conditions which cause scrotum skin swellings include:

Epidermoid Cysts

Epidermoid cysts, which are a type of sebaceous cysts, are smooth, painless, round lumps. They start as small swellings which are a few millimeters in diameter and grow slowly to about 5 cm in diameter. These firm swellings are flesh-colored or yellowish.  They often have a central hole (like the one seen in your picture above).

Epidermoid cysts are treated by removing them surgically. In this procedure the doctor numbs the area around the swelling with local anesthesia and makes a small cut over the cyst. They then apply firm pressure to squeeze out its contents before closing the wound with stitches.

 

Skin Cancers

Cancers like squamous cell carcinoma can also cause scrotum skin swellings. Symptoms of scrotal squamous cell carcinomas include raised papules and plaques (swellings) which increase in size and evolve into ulcers (sores). These swellings may also be associated with inguinal lymphadenopathy (swollen groin glands). Scrotal squamous cell cancer usually develops in men aged older than 50 years and it is primarily an occupational disease which affects chimney sweeps and workers in the textile milling and metalworking industries.

Skin cancers on the scrotumare treated by removing them surgically.

 

Nevi or Moles

Nevi or moles develop when pigmented skin cells known as melanocytes grow in clusters. Common moles can develop on the scrotum and they are usually round, with a smooth surface and even coloration which can range from brown and black to red and pink. Atypical moles (dysplastic nevus) can also develop on the scrotum. They are characterized by an irregular shape and different colors.

Dysplastic moles are treated by removing them surgically. Common moles are observed to see if they will change their size, shape or color. They are removed surgically if they begin changing.

 

Nodular Scabies

Nodular scabies is characterized by swellings on the scrotum which persist after the scabies has been treated. They are thought to be caused by immune reactions rather than by scabies infection.

Nodular scabies is treated by applying mild steroid creams like Hydrocortisone to the scrotum.

 

Syphilis

Patients with tertiary syphilis can develop gumma on their skin, bone and other organs. These nodules or plaques (swellings) are round masses which can destroy surrounding tissues.

Syphilis is treated with injections of the antibiotic benzathine penicillin.

 

Warts

Warts are other common causes of scrotum skin sweellings. Symptoms of scrotum warts include flesh-colored swellings. These genital warts are usually caused by human papilloma virus (HPV) types 6 and 11.

The treatment of anogenital warts is challenging and one can choose to wait for the body to develop an immune reaction which will get rid of the warts or medications like Warticide can be applied on the warts.

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