A Case Report of Scrotal Rejuvenation: Laser Treatment of Angiokeratomas of the Scrotum

Abstract

Scrotal rejuvenation encompasses not only the functional quality but also the aesthetic appearance of the scrotum. It includes medical therapy and procedural interventions to improve scrotal conditions that require morphologic restoration and/or aesthetic alteration. Rejuvenation of the scrotum may be appropriate for aging-related and non-aging-related changes concerning the hair (alopecia and hypertrichosis), the morphology (laxity and wrinkles), and/or the vascularity (angiokeratoma) of the scrotum. Angiokeratomas-typically small, asymptomatic, purple papules-may occur on the scrotum. However, these benign vascular lesions may be of cosmetic concern to the affected individuals; in addition, the angiokeratomas can become an issue of medical importance if they begin to bleed. Multiple locally destructive modalities are available for the treatment of scrotal angiokeratomas; indeed, several lasers have effectively been used to treat angiokeratomas of the scrotum. A 70-year-old man with numerous scrotal angiokeratomas experienced scrotal bleeding in the absence of prior trauma to the area or sexual activity. He presented for treatment to prevent future episodes of spontaneous bleeding from his scrotal angiokeratomas, but he also had not liked the aesthetic appearance of the previously asymptomatic angiokeratomas on his scrotum. His angiokeratomas were successfully treated with three sequential 532-nm potassium titanyl phosphate (KTP) laser sessions, which led to not only functional but also cosmetic improvement of his scrotum. In conclusion, men can develop scrotal changes due to either intrinsic (aging) or extrinsic (trauma) causes, but nonsurgical interventions and surgical procedures are available for the management of these conditions in individuals who desire to rejuvenate their scrotum.

Keywords: Angiokeratoma; Genital; Laser; Rejuvenation; Scrotal; Scrotum; Vagina; Vaginal; Vulva; Vulvar.

Fig. 1a–d

Distant (a, b) and close-up (c, d) views of the right (a, b) and left (b, d) sides of the scrotum of a 70-year-old man show numerous angiokeratomas presenting as small purple papules. He had experienced spontaneous bleeding of his scrotal angiokeratomas

Fig. 2a–d

Distant (a, b) and close-up (c, d) views of the right (a, c) and left (b, d) sides of the scrotum of the 70-year-old man show fewer and less prominent scrotal angiokeratomas after three sessions carried out at 1-month intervals using a 532-nm potassium titanyl phosphate (KTP) frequency-doubled neodymium-doped yttrium aluminum garnet (Nd:YAG) laser. The treatment parameters were: wavelength 532 nm, fluence 11 J/cm², spot size 3 mm, pulse duration 10 ms, cooling 10 ºC, and an endpoint of vessel darkening. There were no subsequent episodes of scrotal bleeding