This benign formation is formed due to blockage of the excretory duct of the sebaceous gland. It can be single or multiple, when the entire surface of the scrotum is covered with a large amount of atheroma, resembling a pustular rash. In the latter case, the man is diagnosed with atheromatosis.
Atheroma, or sebaceous cyst, develops in the hair follicle. For various reasons, the excretory duct turns out to be blocked, and the secret cannot find a way out. Mixing with keratinized skin cells, it accumulates in the sebaceous gland, stretching it and forming a seal, the color of which is somewhat lighter than the color of the surrounding skin. In the center of atheroma, you can find a black point - a clogged mouth of the gland.
- Causes of the appearance of scrotal atheroma
- Diagnostics and differentiation
- Treatment of atheroma
In consistency, the formation is soft, elastic, has an even rounded contour, reaches a size of 1-1.5 cm in diameter. The primary cyst of the sebaceous gland is painless as long as it does not become inflamed. In contrast, secondary atheroma has a denser consistency, painful when pressed. Secondary cysts of the sebaceous glands of the scrotum appear in large numbers in men suffering from seborrhea and hyperhidrosis, and are diagnosed as seborrheic cysts, or Fordyce cysts.
Due to friction against linen and mechanical damage to the skin, atheromas of the scrotum can spontaneously open. The ingress of pathogenic bacteria into the cyst against a background of reduced immunity leads to inflammation and suppuration of the formation.
Possible options for the development of atheroma:
- Healing after a spontaneous opening;
- Formation of an abscess;
- The emergence of phlegmon.
The transformation of atheroma into a malignant tumor occurs extremely rarely, only with the addition of additional factors of malignancy. It is important to differentiate atheroma from syphilitic ulcers, lipomas, fibromas. After a spontaneous opening, a relapse of the disease may occur, because the remaining cells of the cyst capsule will provoke the formation of a new atheroma.
Causes of the appearance of scrotal atheroma
A sebaceous gland cyst in the scrotum is diagnosed in every fifth man. This incidence of atheroma is associated with the structural features of the male reproductive system. The testicles in the scrotum perform an important function - the production of full-fledged sperm. Many sebaceous glands maintain a stable temperature of this organ. If the rules of personal hygiene are not followed, their excretory ducts can become clogged.
Other reasons for the formation of atheroma:
- Violation of lipid metabolism;
- Hormonal imbalance;
- The predominance of fatty foods in the diet.
With increased sweating, a lot of fluid is secreted through the sebaceous glands of the scrotum, which contains salts and hormones. Salt deposits clog ducts and clog pores.
In conditions of excess testosterone in the blood, the secretion of the sebaceous glands increases. Removal of excess sebum is difficult, it accumulates in the cyst cavity. In case of disturbances in the diet, excessive consumption of fatty foods, spices, fried and spicy foods, specific compounds are formed in the secretions of the sweat glands that irritate the skin. This factor can also lead to the formation of atheroma.
Diagnostics and differentiation
To determine the tactics of treatment, the doctor must make sure that the diagnosis is correct.
For this, a visual examination and, if necessary, laboratory tests are carried out:
- Blood test for hormones;
- Complete blood count to determine the content of leukocytes;
- A smear if there is ulceration at the site of the atheroma.
With an increased content of testosterone in the blood, it can be concluded that the cause of the appearance of a neoplasm is hormonal imbalance. An increase in the concentration of leukocytes, which are a kind of defense of the body against pathogenic bacteria, indicates the development of an inflammatory process.
The study of smear data from an ulcer on the surface of an atheroma is carried out in order to determine the type of pathogens that caused it. The doctor must rule out the likelihood of developing other pathologies with similar symptoms.
Directions of differential diagnosis (from which you need to distinguish atheroma):
Fibroma is a hypertrophied increase in connective tissue, located in the deeper layers of the skin, not adhered to its surface;
- Lipoma - has a softer consistency, less tightly adhered to the surface of the skin, there is no black point of the clogged mouth of the sebaceous gland;
- Hygroma is a cyst filled with serous fluid and fused not with the skin, but with nearby tissues.
Treatment of atheroma
At the initial stage of development, the cyst of the sebaceous gland does not cause any unpleasant sensations, however, its constant injury can lead to the development of an abscess or phlegmon, when the inflammation spreads through the subcutaneous tissue. To avoid this, it is advisable to remove the atheroma in the "cold" period. Self-extrusion of cysts is unacceptable, as it carries the risk of infection and the appearance of a hematoma.
After a man reaches the age of 35 years, a small atheroma can spontaneously disappear without treatment. This is due to a decrease in the production of testosterone and sebum. Large atheromas must be surgically removed. No other methods will bring final recovery until the cyst capsule is removed.
Methods for the treatment of scrotal atheroma:
- Excision with exfoliation of the cyst;
- Opening of the inflamed cyst and its drainage.
Removal of large atheroma is carried out using local anesthesia. The area of the scrotum is anesthetized, the top layer of the skin is opened, the cyst is removed along with the capsule. For several months, no trace remains of the scar. Such intervention does not affect sexual function.
Electrocoagulation is the "evaporation" of atheroma using high frequency current. In this case, the vessels are cauterized, therefore, blood loss with such an intervention is minimal. The risk of recurrence after electrocautery is only 3%.
In case of suppuration of the cysts, the inflamed capsule of atheroma is first opened, its contents are removed, and drainage is installed. After the inflammation subsides, the capsule is exfoliated.
To prevent the appearance of a sebaceous gland cyst on the scrotum, you must carefully follow the rules of personal hygiene. Toilet of the genitals using soap or special cosmetics for intimate hygiene is a must. Steam baths can be used to cleanse the skin and prevent the appearance of atheroma.
Reasonable consumption of fats and carbohydrates will help not only maintain optimal weight, but also avoid clogging of the sebaceous glands. An additional measure for the prevention of atheroma of the scrotum is wearing loose underwear made of natural fabrics to prevent overheating of the groin area.
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.