Multiple epidermal cysts of scrotum.

A 37 year old male presented to the surgical outpatient department of Mysore Medical College and Research Institute, Mysore, Karnataka, India, in June 2013, with multiple painless swellings over scrotum (Figure) since last one year. On examination, multiple swellings were found arising from scrotal skin, which were non-tender and firm in consistency. The findings were consistent with a diagnosis of multiple epidermal cysts of scrotum. The patient was advised surgery i.e. complete excision and scrotoplasty, however he refused surgery. He was advised to report in case of infection or other complications, but has not come till date.

Fig

Multiple epidermal cysts of scrotum.

Epidermal cysts are the most common benign epithelial cysts and are generally devoid of malignant potential. These occur commonly in hair-bearing areas mostly on the scalp, also on the face, neck, back and scrotum1. Histologically, cysts are lined by stratified squamous epithelium and contain loosely packed keratin debris and cholesterol. Gold standard treatment for epidermal cyst is complete excision of sac and its contents2. Idiopathic scrotal calcinosis is an important differential diagnosis and can be differentiated on histology.