Red scrotum syndrome: idiopathic neurovascular phenomenon or steroid addiction?

Sexual Health ◽  
2013 ◽  
Vol 10 (5) ◽  
pp. 452 ◽  
Author(s):  
Tarun Narang ◽  
Muthu Sendhil Kumaran ◽  
Sunil Dogra ◽  
Uma Nahar Saikia ◽  
Bhushan Kumar

Background 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. Objective: To evaluate the clinicoepidemiological profile and assess the efficacy of various treatment modalities in addition to corticosteroid abstinence in the treatment of RSS. Methods: 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. Results: 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. Conclusions: 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.

2019 ◽  
Author(s):  
Catriona I. Wootton ◽  
Mick Soukavong ◽  
Sonexai Kidoikhammouan ◽  
Bounthome Samountry ◽  
John S.C. English ◽  
...  

AbstractBackgroundDermatological services in Laos, South East Asia are limited to the capital and patch testing is currently not available, so no data exists regarding the common cutaneous allergens in this population.ObjectivesThe aim of this study was to document common allergens in medical students in Laos. Patients/Materials/MethodsOne hundred and fifty medical students were patch tested using TRUE Test® panels 1 to 3 (35 allergens). Readings were taken at Days 2 and 4.ResultsThirty-eight students (25.3%) had a positive reaction to at least one allergen, accounting for 52 reactions in total. The proportion of the students with positive patch test reading was significantly higher in the female [33/96 (34%)] than in the male [5/54 (9%)], p<0.001. The most common allergens were: nickel (10%), gold (6.6%), thiomersal (6.6%), cobalt dichloride (2%) and p-tert-Butylphenol formaldehyde resin (2%). Balsam of Peru (0.66%), black rubber mix (0.66%), Cl+Me-Isothiazolinone (0.66%), fragrance mix 1 (0.66%), quinolone mix (0.66%), methyldibromo glutaronitrile (0.66%), mercapto mix (0.66%), epoxy resin (0.66%), paraben mix (0.66%), thiuram (0.66%) and wool alcohols (0.66%) accounted for all of the other positive reactions.ConclusionThis study represents the first documented patch test results in Lao medical students and in the adult Lao population. The results of this study will inform any future research into contact allergy in Laos and give an insight into the background level of contact sensitivity in this population.


2018 ◽  
Vol 2 (2) ◽  
pp. 96-110
Author(s):  
Grace Shin ◽  
Michael Smith ◽  
Butros Toro ◽  
Adam Ehrlich ◽  
Sanjana Luther ◽  
...  

BackgroundIrritable Bowel Syndrome (IBS) is a functional gastrointestinal (GI) disorder of unknown etiology.ObjectiveWe sought to investigate whether specific type 4 food allergens identified by skin patch testing, when eliminated from the diet, alleviate symptoms of IBS.MethodsIn this case series, skin patch testing was performed on 60 IBS patients using an extensive panel of type 4 food allergens after which food avoidance diets directed by the patch test results were implemented. Questionnaires assessing abdominal pain/discomfort and global improvement in IBS symptoms were used to assess one month and three or more month outcomes. ResultsThere were statistically significant improvements in abdominal pain/discomfort and in global IBS symptoms after one month and again at an average of 7.6 months of patch test-guided food avoidance.ConclusionsSustained improvement with avoidance of type 4 food allergens identified by skin patch testing suggests a role for delayed-type food hypersensitivities in the pathogenesis of some cases of IBS. A subset of patients whose IBS symptoms resolve completely may be better characterized as having a newly proposed disease, allergic contact enteritis (ACE).  


Author(s):  
Vikram K. Mahajan ◽  
Pushpinder Singh Chauhan ◽  
Karaninder Singh Mehta ◽  
Anuj Sharma ◽  
Bhumika Chowdhary ◽  
...  

Background: The reliability of patch testing with expired Indian standard patch test kits has been not evaluated before. Methods: Thirty adults (men:women 25:5) with allergic contact dermatitis were divided into three groups of ten patients each for patch testing by Finn chamber® method using Indian standard patch test kits having expiry in 2016, 2015 and 2014. The results were compared with those from a new kit with 2018 expiry. Results: Ten patients in group-1, eight patients in group-2 and seven patients in group-3 developed positive reactions of identical intensities and mostly from identical allergens from all four kits. The major contact allergens eliciting positive reactions of identical intensities were parthenium in nine, five and three patients, colophony in four, one and zero patients, fragrance mix in three, three and one patients, thiuram mix in three, one and one patients, and paraphenylene diamine in two, one and three patients from group-1,-2, and -3, respectively. Limitations: Small number of patients in each group remains the major limitation of the study. Whether or not these results can be extrapolated with patch test results from other similar patch test kits available across countries also needs confirmation. Conclusion: The patch test allergens can be used beyond labeled expiry dates but needs confirmation by a few large studies and using other available patch test kits. This is important as the relevance of patch test results for individual allergen in this scenario may remain debatable requiring careful interpretation.


Author(s):  
Rahima S. ◽  
Najeeba Riyaz ◽  
Saleem P. M. ◽  
Sarita S.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Foot dermatoses are a common malady in children. It has a varied presentation ranging from patchy fissured scaly lesions to disabling highly inflammatory vesicular eruption. A role for foot wear exacerbating these dermatoses is a possibility, which could be confirmed by patch testing.</span><span lang="EN-IN">To evaluate the role of patch testing in   determining the allergen either causing or exacerbating various foot dermatoses in children.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Patch testing was done in 40   children with various foot dermatoses using the standard footwear series and the results were read after 48 hours, 96 hours and again after 7 days. Also, skin biopsy was done in 10 cases from the representative lesions</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Patch test was positive in 24(60%) patients to different antigens. Disperse orange (25%) was found to be the commonest allergen followed by epoxy resin (15%),   neomycin sulphate (12.5%) and black rubber mix (10%). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Patch testing has a major role in finding out the causative agent or at least the exacerbating footwear in various foot dermatoses. Disperse orange was found to be the most common allergen. The diagnosis of acrodermatitis or JPD should not deter doing a patch testing.</span></p><p> </p>


2014 ◽  
Vol 76 (6) ◽  
pp. 583-587
Author(s):  
Eriko ITOH ◽  
Takeshi NAKAHARA ◽  
Makiko KIDO-NAKAHARA ◽  
Futoshi KOHDA ◽  
Masakgazu TAKAHARA ◽  
...  

2019 ◽  
Vol 29 (3) ◽  
pp. 113-119
Author(s):  
Semih GÜDER ◽  
Şafak METEKOĞLU ◽  
İlteriş Oğuz TOPAL ◽  
Mehmet MELİKOĞLU

Sign in / Sign up

Export Citation Format

Share Document