Idiopathic Scrotal Calcinosis: Contemporary Management

The objective of this chapter is to highlight the advances made in the diagnosis and management of idiopathic scrotal calcinosis in contemporary times and emphasize points that allow for good aesthetic outcomes.

Idiopathic scrotal calcinosis is a rare benign condition that is characterized by the deposition of calcium in the scrotal dermis. This leads to the formation of a single or multiple calcified nodules of different sizes. It commonly begins in adolescence and early adulthood. Histologically, there is a granulomatous reaction to calcium deposits that contain multinucleated giant cells of the foreign body type appearing as dermal nodules. Patients most commonly present because of concern about cosmesis and itching. Diagnosis is mainly clinical and confirmed with histology of excised nodules. Surgery that involves the excision of the nodules either single or en-mass is the treatment approach, and it is to reduce symptoms and improve cosmesis. The preservation of an uninvolved scrotal median raphe allows the scrotum to assume normal configuration over time. There are reports of recurrence on follow up and patients need to be counselled appropriately. Though newer modalities such as the use of carbon dioxide laser and the erbium: YAG Laser have been reported to offer a better aesthetic outcome compared with traditional surgery, comparative studies are needed to validate the observation.