Fact-sheet: Acute idiopathic scrotal edema
Updated on 07/01/2020 at 9:24 AM
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Definition
Idiopathic acute scrotal edema (IASE) preferentially affects children aged 5 to 10 years. It is a benign dermatosis with spontaneously favorable outcome but which, in some cases, leads to surgical exploration to rule out testicular torsion.
Its etiology is unknown (allergic?)
Clinical features
Most often unilateral scrotal edema, but may be bilateral, extending toward the inguinal folds, the perineum, the ipsilateral buttock, or the penis.
The overlying skin is erythematous with little inflammation.
Associated scrotal pain without a precise point of tenderness on palpation.
General condition preserved.
No associated signs.
Laboratory findings
Mild leukocytosis, without neutrophilia or inflammatory syndrome.
Possible hypereosinophilia.
Ultrasound
"Fountain sign," with the presence of scrotal skin edema and increased blood flow on Doppler
Hydrocele
Normal testis
Allows exclusion of differential diagnoses
Management
No consensus on treatment:
Watchful waiting
Antihistamines - Analgesics / NSAIDs
The outcome is favorable.
Differential diagnosis
Testicular torsion or torsion of the appendages
Epididymo-orchitis
Scrotal trauma
Strangulated inguinal hernia
Testicular tumor with internal hemorrhage
Hydrocele or varicocele
Insect bites
Infectious dermohypodermitis
Recurrent acute perineal erythema
Orchitis in the setting of a viral illness, typhoid fever, or Henoch-Schönlein purpura
Drug allergy
Fournier gangrene