What treatment do you recommend for scrotal dermatitis? — Jayakar Thomas, MD, PhD, Chennai, India

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Scrotal dermatitis may be idiopathic, secondary to a contact etiology (allergic or irritant), the result of scrotal involvement of a systemic dermatosis (e.g., lichen planus or psoriasis), caused by an infection (dermatophyte or candida) or infestation (scabies or lice), or—less likely—an unusual sequela of an underlying neoplastic process (e.g., squamous cell carcinoma or extramammary Paget disease).

Symptomatic treatment could begin with a topical low- to mid-potency corticosteroid cream or ointment. If a fungal etiology is suspected, a topical or systemic antimycotic agent could be added. Consider a biopsy if the dermatitis persists or recurs. — Philip R. Cohen, MD (167-2)

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