Sharply limited chronic erythema of the ventral side of the scrotum. Recurrent pulling or burning pain, no itching, therefore no scratching artifacts.
Manifestation: older men
Etiology: Unclear, possibly neurogenic inflammation, special form of erythromelalgia or rosacea.
Therapy: Not established - external steroids lead to worsening - possibly calcineurin inhibitors, moisturizers, possibly systemic analgesics. There are positive reports with doxycycline over a longer period of time, good results are reported with pregabalin and gabapentin or amitryptiline or carvediol (beta blocker).
Differential diagnosis: psoriasis inversa, atopic dermatitis, mycoses, erythrasma, allergic contact dermatitis.