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CORRESPONDENCE |
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| Year : 2020 | Volume
: 65
| Issue : 3 | Page : 248-249 |
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| Multiple penoscrotal cysts |
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Manojit Midya
Department of Burns and Plastic Surgery, AIIMS, Jodhpur, Rajasthan, India
| Date of Web Publication | 14-Apr-2020 |
Correspondence Address:
Manojit Midya
Department of Burns and Plastic Surgery, AIIMS, Jodhpur, Rajasthan
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijd.IJD_709_18
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How to cite this article:
Midya M. Multiple penoscrotal cysts. Indian J Dermatol 2020;65:248-9 |
Sir,
Epidermoid cysts (EC) are the most common skin cyst found on the various regions of the body.[1] EC in the penoscrotal region is mainly seen in scrotum. Penile epidermoid cyst (PEC) is a rare entity.[1],[2] Even though isolated cases of PEC are present in the literature;[2] case of multiple penoscrotal EC is unheard of.
A 25-year-old apparently healthy male arrived in our outpatient department with multiple swellings all over the penis and scrotum. He visited us for purely cosmetic reasons in view of his ensuing marriage prospects. There were multiple small nonuniform-sized, nontender cysts present all over the penoscrotal region [Figure 1] and [Figure 2]. His scrotal sonography showed normal testes. An excision biopsy of one of the penile cysts revealed the suggestive features of EC [Figure 3]. He was advised cyst excision but refused surgery. | Figure 1: Dorsal view of the penis and scrotum showing multiple cystic lesions of varying sizes over the penile skin and scrotal wall
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 | Figure 2: Ventrolateral view of the penis and scrotum showing several cystic lesion above the root of penis near the median raphe along with scattered cystic lesions on the scrotal wall
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 | Figure 3: Section shows stratified squamous linng epithelium of cyst with hyperkeratinizaton (H and E, ×400)
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Etiology of such cysts is unclear.[2] The suggested theories are - it may be congenital due to abnormal embryological closure of median raphe[2] or traumatic due to mechanical implantation of epidermal cells.[3] The common differential diagnosis of PEC is dermoid cyst, teratoma, pilonidal cyst, and urethral diverticula.[1] Ultrasonography can be used to rule out intrascrotal extension of the cyst. Indications of treatment are pain during intercourse and secondary infection.[1] The optimum treatment suggested is complete excision of cyst along with its wall to prevent recurrence.[4] The prognosis is fair with no malignancy reported in PEC to the best of our knowledge.[2],[5]
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Kalkan M, Sahin C, Ozyilmaz S, Ucmakli E. Multiple epidermoid cysts of penis. Eur J Gen Med 2012;9(Suppl 1):60-2.  |
| 2. | Suwa M, Takeda M, Bilim V, Takahashi K. Epidermoid cysts of penis: A case report and review of literature. Int J Urol 2000;7:431-3. |
| 3. | Laurenti C, De Dominicis C. A cyst in the penis of a child. Br J Urol 1978;50:213. |
| 4. | Kawai N, Sakagami H, Awata S, Kojima Y, Tatsura H, Sasaki S. Epidermoid cyst of the scrotum: A case report. Acta Urol Jpn 1996;42:609-11. |
| 5. | Unsal A, Cimentepe E, Saglam R. Penile epidermoid cyst in an elderly patient. Int Urol Nephrol 2002;34:229-30. |
[Figure 1], [Figure 2], [Figure 3] |
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