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Case 188: Scrotal lesion

A 36 year old man presents with a painful lesion on his scrotum. Initially ne noticed a single nodule but several others have developed. The largest is now painful. He is concerned about cancer.

1. What is the diagnosis?

Multiple sebaceous cysts are evident with a typical rounded appearance with central puntum and thick white sebaceous material contained within the cysts. The largest cyst is surrounded by erythema and oedema suggesting that it is infected.

2. What are the principles of management?

Antibiotics and surgical removal of the sebaceous material. Once infected these cysts are more difficult to excise without rupture. It is important to remmove the entire cyst wall to prevent recurrence.