Juvenile gangrenous vasculitis of the scrotum: A rare cause of genital ulcer

Abstract

Juvenile gangrenous vasculitis of the scrotum is a rare entity of unknown aetiology which should be considered in the differential diagnosis of genital ulcers, mainly with those caused by sexually transmitted infections. The authors report a case of a 23year-old patient who presented a single painful scrotal ulcer developing shortly after an episode of pharyngotonsillitis. The ulcer was treated with oral corticosteroids with total healing and no relapse in over two years of follow-up.

Juvenile gangrenous vasculitis of the scrotum: systematic review

“…Bacteriological cultures of scrotal ulcer exudates were negative 3,8,13,14 . Immunological studies were also performed and yielded negative results 8 . The immunological tests included: antinuclear antibodies, anti‐double‐stranded DNA antibodies, c‐ and p‐antineutrophil cytoplasmic antibodies, immunoglobulin concentrations, complement components, and cryoglobulins 8,14 .…”

“…Immunological studies were also performed and yielded negative results 8 . The immunological tests included: antinuclear antibodies, anti‐double‐stranded DNA antibodies, c‐ and p‐antineutrophil cytoplasmic antibodies, immunoglobulin concentrations, complement components, and cryoglobulins 8,14 . Chest x‐ray and ultrasound were performed in one patient and were unremarkable 14 .…”

“…He was febrile and had multiple painful scrotal ulcers 9 . A total of 64.7% ( n = 11) of patients had concomitant or a recent history of upper respiratory tract symptoms 3,5,7,8,10–13,15,16,18 . Most of the patients (88.2%, n = 15) had a fever ranging between 38°C and 39.6°C.…”

“…Initial investigation included laboratory tests and histopathological studies. Laboratory values were as follows: a moderate increase of erythrocyte sedimentation rate (38–75 mm/l/h) (47%, n = 8), 3,5,8,9,11,12,14,15 elevated C‐reactive protein (CRP) (191–1500 mg/l) (58.8%, n = 10), 3,8,9,13,15–17 leukocytosis (14–22.5 × 10 9 /l) (58.8%, n = 10), 3,7,10–13,15,17 neutrophilia (8.97 × 109) (41.1%, n = 7) 3,11–13,16,17 . Gil et al.…”

“…Re‐epithelization occurred after a few days or 1 month. Patients remained free of lesions over a period ranging from 6 months to 2 years of follow‐up 5,8,12–15,18 . An atrophic scar was reported in two patients (11.7%) treated with oral prednisolone 8,14 .…”