Narang Tarun, Kumaran Muthu Sendhil, Dogra Sunil, Saikia Uma Nahar, Kumar Bhushan
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Sex Health. 2013 Nov;10(5):452-5. doi: 10.1071/SH13052.
Red scrotum syndrome (RSS) is not infrequent but is often misdiagnosed or underdiagnosed, and seldom reported. The exact etiopathogeneis is still unknown but it almost always follows the prolonged application of topical corticosteroids and is characterised by persistent erythema of the scrotum, associated with severe itching, hyperalgesia and a burning sensation.
To evaluate the clinicoepidemiological profile and assess the efficacy of various treatment modalities in addition to corticosteroid abstinence in the treatment of RSS.
Twelve patients with RSS, who presented to us during 2010 and 2011, were identified, and various aspects of their illness and treatment were studied. Patch testing was performed in all patients. A skin biopsy was done in seven patients.
The average age of the patients was 45.83 years (26-62 years). The average duration of illness or the duration of topical steroid use was 27.41 months (6-56 months). Psychiatric comorbidities were seen in 9 (75%) out of 12 patients. Histopathology revealed features resembling erythematotelengiectatic rosacea in four of the biopsied patients. Patch test results were negative. All patients reported improvement of their symptoms within 4 weeks of starting doxycycline with amitriptyline or pregabalin; the treatment had to be continued for 3-4 months.
RSS appears to be a manifestation of corticosteroid misuse rather than a primary disease. We suggest that RSS is a rosacea-like dermatosis or steroid-induced rebound vasodilation based on clinical and histopathological features. Our patients responded to cessation of steroids and doxycycline in combination with amitryptaline or pregabalin.
红阴囊综合征（RSS）并不罕见，但常被误诊或漏诊，且鲜有报道。其确切病因尚不清楚，但几乎总是在长期外用糖皮质激素后出现，特征为阴囊持续红斑，伴有严重瘙痒、痛觉过敏和烧灼感。
评估红阴囊综合征的临床流行病学特征，并评估除停用糖皮质激素外各种治疗方式的疗效。
确定了2010年至2011年期间就诊于我院的12例红阴囊综合征患者，并对其病情和治疗的各个方面进行了研究。所有患者均进行了斑贴试验。7例患者进行了皮肤活检。
患者的平均年龄为45.83岁（26 - 62岁）。疾病平均病程或外用糖皮质激素使用时间为27.41个月（6 - 56个月）。12例患者中有9例（75%）存在精神疾病共病。组织病理学显示，4例活检患者具有类似红斑毛细血管扩张型酒渣鼻的特征。斑贴试验结果为阴性。所有患者在开始使用多西环素联合阿米替林或普瑞巴林治疗4周内症状均有改善；治疗需持续3 - 4个月。
红阴囊综合征似乎是糖皮质激素滥用的表现而非原发性疾病。基于临床和组织病理学特征，我们认为红阴囊综合征是一种酒渣鼻样皮肤病或类固醇诱导的反弹性血管扩张。我们的患者对停用类固醇以及多西环素联合阿米替林或普瑞巴林治疗有反应。
