Fordyce Angiokeratoma: Comparison of Cryotherapy and Electrocauterization Treatments

Abstract

Fordyce angiokeratoma is a benign lesion commonly developing on the scrotal skin. The incidence increases with age. About half of these lesions may be symptomatic and frequently cause itching and bleeding. Although the treatment is not always considered necessary, several treatment methods are used for symptomatic cases, especially for cosmetic purposes. Treatment options include surgical excision, laser ablation, electrocoagulation, cryotherapy, and sclerotherapy. The most widely used methods are electrocoagulation and cryotherapy. Although these two methods are similarly effective and safe, there are differences in means of patient comfort and cosmetic outcomes. Patient comfort can be defined as pain management during the procedure and the healing period. Bleeding and wound infection are other parameters that may decrease patient comfort. Patients would prefer treatment methods with less or no pain and shorter recovery periods, healthcare providers, and insurance. The cosmetic result is another critical issue, especially for patients with multiple lesions. Treatment methods avoiding genital scars are more likely to meet the aesthetic demands of the patients.

Intralesional sclerotherapy for angiokeratoma of Fordyce: A case report

“…The progression of angiokeratomas of Fordyce is often gradual and, while typically asymptomatic, it can be distressing for some patients due to the potential for pain, itching, and bleeding, particularly during sexual activity, causing heightened anxiety. 3 Managing angiokeratoma of Fordyce poses challenges due to its multifocal nature, especially in individuals with dark skin who may exhibit increased skin thickness and hyperkeratosis. Traditional treatment modalities, such as excision, electrocoagulation, cryotherapy, and lasers, have limitations, especially in cases involving multiple lesions.…”

“…Traditional treatment modalities, such as excision, electrocoagulation, cryotherapy, and lasers, have limitations, especially in cases involving multiple lesions. 3 – 6 Excision may be restricted by the presence of multiple lesions or those with intricate patterns that are challenging to excise. Electrocoagulation and cryotherapy are limited by their potential to induce pigmentary changes and scarring.…”

“…Electrocoagulation and cryotherapy are limited by their potential to induce pigmentary changes and scarring. 3 – 5 …”

“… 2 Various treatment modalities have been employed for angiokeratomas, including electrocautery, cryotherapy, excision, laser therapy, and, more recently, sclerotherapy. 3 – 6 With only one published case report from 2010 showcasing its efficacy, sclerotherapy deserves reevaluation. 6 This case report research delves into the potential of 3% sodium tetradecyl sulfate (STS) as a cost-effective, patient-friendly, and machinery-free alternative to conventional modalities, paving the way for a potentially transformative approach to managing angiokeratomas.…”