Testicular Skin Lesions: Causes and Treatments

There is a wound on the scrotum?

Hello Doctor: I have a round bump on my testicle that is about the size of a soybean, with a small wound on top of it.
A few days ago, I squeezed it, and the bump released a fluid that resembled blood.
After that, the bump became flatter, but soon after, blood started to cover the entire wound.
The bump seems to have slightly swollen again and is not easily forming a scab, as blood keeps oozing out.
Doctor, could this be a lump?

Nìmíng, 10~19 year old female. Ask Date: 2011/08/16

Dr. Lin Yisheng reply Urology

This condition is generally due to subcutaneous folliculitis, which occurs when the opening becomes blocked, leading to the accumulation of pus beneath the skin.
It typically presents as a nodule about the size of a soybean, with the skin color also appearing yellowish.
After a period of inflammation, an abscess may form, often resulting in a small wound on the scrotal skin from which pus can drain.
Once the pus drains, the nodule may flatten and shrink, but if the wound becomes blocked again, the nodule may reform.
This is a hard lump, but it is mostly an abscess nodule caused by infection.
Treatment options are twofold: the first is oral antibiotics combined with wound care, while avoiding water exposure to the wound.
The downside is the possibility of reinfection at the same site.
The second option is surgical excision of the nodule, with the downside being that the healing of an infected wound may be slower and there is a risk of wound infection.
It is recommended that you seek treatment at a urology clinic.
Thank you!

Reply Date: 2011/08/16

More Info

When it comes to skin lesions on the testicles, it's essential to approach the situation with caution and a thorough understanding of potential causes and treatments. Based on your description, it sounds like you may be dealing with a sebaceous cyst, folliculitis, or possibly an ingrown hair, but it’s crucial to have a healthcare professional evaluate the lesion for an accurate diagnosis.

Causes of Testicular Skin Lesions
1. Sebaceous Cysts: These are common benign lumps that can occur on the skin, including the genital area. They are usually painless and filled with a thick, yellowish substance. If they become inflamed or infected, they can rupture, leading to the symptoms you described.

2. Folliculitis: This is an inflammation of the hair follicles, often caused by bacterial infection. It can lead to red, swollen bumps that may resemble pimples. If you have been squeezing the lesion, it could have exacerbated the condition, leading to further inflammation and bleeding.

3. Infections: Bacterial or fungal infections can cause lesions on the skin. If the area is red, swollen, and painful, it may indicate an infection that requires medical treatment.

4. Other Conditions: Conditions such as genital warts (caused by human papillomavirus), molluscum contagiosum, or even more serious issues like testicular cancer can present as lumps or lesions. While these are less common, they should not be ruled out without proper examination.

Treatment Options
1. Avoid Squeezing: It’s crucial to avoid squeezing or picking at the lesion, as this can introduce bacteria and lead to infection.
2. Keep the Area Clean: Maintain good hygiene by gently washing the area with mild soap and water. Avoid harsh soaps or scrubs that can irritate the skin further.

3. Topical Treatments: If the lesion is due to folliculitis, over-the-counter topical antibiotics may help. However, if there is significant redness, swelling, or pain, a prescription antibiotic may be necessary.

4. Warm Compresses: Applying a warm compress to the area can help reduce inflammation and promote drainage if there is an underlying cyst or abscess.

5. Consult a Healthcare Provider: Given the symptoms you described, especially the bleeding and difficulty in healing, it is essential to consult a healthcare provider. They may perform a physical examination and possibly a biopsy to determine the exact nature of the lesion.

6. Surgical Intervention: If a sebaceous cyst is diagnosed and is causing discomfort or recurrent issues, surgical removal may be recommended.

When to Seek Immediate Care
If you experience any of the following symptoms, seek immediate medical attention:
- Increased swelling or redness around the lesion
- Fever or chills, which may indicate an infection
- Severe pain or discomfort
- Any changes in the appearance of the lesion, such as rapid growth or changes in color

Conclusion
In summary, while there are several potential causes for the skin lesion on your testicle, it is vital to have it evaluated by a healthcare professional for an accurate diagnosis and appropriate treatment. Avoid self-treatment methods like squeezing, and focus on maintaining hygiene and monitoring the lesion for any changes. Early intervention can prevent complications and ensure proper care.

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