A Soft Lesion on the Scrotum: A Quiz

Abstract

An 18-month-old boy presented with an asymptomatic skin lesion of the scrotum that had been present since birth. Physical examination revealed a flesh-coloured, large, soft gyrate plaque with a few overlying scattered pores on the left side of the scrotum (Fig. 1A and B). There was no family history of a similar condition. In addition, the parents reported that the left testis was not palpable under the scrotal lesion. A skin biopsy specimen from the plaque, including a pore, showed epidermal papillomatosis as well as dermal deposition of mature adipocytes among collagen fibres (Fig. 2A and B). The pore lesion showed features of a comedone. On physical examination, the right testis moved spontaneously out of the scrotum, but could be returned to the scrotum with manipulation (retractile testis). What is your diagnosi’ See next page for answer.