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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 number of atheromas, resembling a pustular rash. In the latter case, the man is diagnosed with atheromatosis.
Atheroma, or sebaceous gland cyst, develops in the hair follicle. The excretory duct for various reasons is clogged, 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 the atheroma, a black dot can be found – a clogged mouth of the gland.
By consistency, the formation is soft, elastic, has a smooth rounded contour, reaches a value of 1-1,5 cm in diameter. A primary sebaceous cyst is painless until it becomes 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 on linen and mechanical damage to the skin, atheromas of the scrotum can spontaneously open. The entry of pathogenic bacteria into the cyst against the background of reduced immunity leads to inflammation and suppuration of the formation.
Possible options for the development of atheroma:
Healing after spontaneous opening;
abscess formation;
ulceration;
The appearance of phlegmon.
The transformation of atheroma into a malignant tumor occurs extremely rarely, only when additional malignancy factors are added. It is important to differentiate atheroma from syphilitic ulcer, lipoma, fibroma. After 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 atheroma of the scrotum
A sebaceous cyst in the scrotum is diagnosed in every fifth man. This frequency of occurrence of atheroma is associated with structural features of the male reproductive system. The testicles, located in the scrotum, perform an important function – the production of full-fledged spermatozoa. Many sebaceous glands maintain a stable temperature of this organ. If the rules of personal hygiene are not observed, their excretory ducts may become clogged.
Other reasons for the formation of atheroma:
Violation of lipid metabolism;
Hormonal imbalance;
Hyperhidrosis;
The predominance of fatty foods in the diet.
With increased sweating, a lot of fluid is released through the sebaceous glands of the scrotum, which contains salts and hormones. Salt deposits clog the ducts and clog the 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 cavity of the cyst. In violation of 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.
Diagnosis and differentiation
To determine the tactics of treatment, the doctor must make sure that the diagnosis is correct.
For this, a visual inspection and, if necessary, laboratory tests are carried out:
Blood test for hormones;
General blood test to determine the content of leukocytes;
A smear if there is ulceration at the site of atheroma.
With an increased content of testosterone in the blood, it can be concluded that the cause of the neoplasm is a hormonal imbalance. An increase in the concentration of leukocytes, which are a kind of protection of the body from pathogenic bacteria, indicates the development of an inflammatory process.
The study of smear data from an ulcer on the surface of atheroma is carried out in order to determine the type of pathogens that caused it. The doctor must exclude the possibility of developing other pathologies with similar symptoms.
Directions of differential diagnosis (from which it is necessary to distinguish atheroma):
Fibroma – a hypertrophied increase in connective tissue, located in the deeper layers of the skin, not soldered to its surface;
Lipoma – has a softer texture, less tightly soldered to the surface of the skin, there is no black dot of the clogged mouth of the sebaceous gland;
Hygroma – is a cyst filled with serous fluid and soldered not to the skin, but to nearby tissues.
Treatment of atheroma
In the initial stage of development, the cyst of the sebaceous gland does not cause any discomfort, however, its constant injury can lead to the development of an abscess or phlegmon, when inflammation spreads through the subcutaneous tissue. To avoid this, it is desirable to remove the atheroma in the “cold” period. Independent 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, small atheroma may spontaneously disappear without treatment. This is due to a decrease in the production of testosterone and sebum. Large atheromas are subject to surgical removal. No other methods will bring final recovery until the cyst capsule is removed.
Treatment methods for atheroma of the scrotum:
Excision with husking of the cyst;
Electrocoagulation;
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. Within a few months, no traces remain of the scar. This intervention does not affect sexual function.
Electrocoagulation is the “evaporation” of atheroma using a high frequency current. In this case, cauterization of blood vessels is carried out, so blood loss during such an intervention is minimal. The risk of recurrence after electrocoagulation is only 3%.
In case of suppuration of the cyst, the inflamed atheroma capsule is first opened, its contents are removed, and drainage is established. After the inflammation subsides, the capsule is husked.
Prevention
To prevent the appearance of a sebaceous gland cyst on the scrotum, you must carefully observe the rules of personal hygiene. The toilet of the genital organs 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 from natural fabrics to prevent overheating of the groin area.