title: Scrotodynia: Diagnostic and Therapeutic Challenge.
abstract: Case 1 A 35-year-old married man presented with diffuse burning of the scrotum for 6 months' duration that was aggravated by sitting and wearing tight-fitting undergarments. He reported a history of sexual exposure 6 months prior, after which the complaint started. Clinical examination of the scrotal skin, testis, epididymis, penis, and perianal area did not reveal any abnormality. Rectal examination was performed to rule out chronic proctitis. Investigations were performed to exclude sexually transmitted infections. Ultrasonography of the abdomen and pelvis was ordered to rule out organic cause. The patient experienced guilt from the exposure because he was married, and therefore was referred to the psychiatrist to rule out psychological problems. A diagnosis of major depressive disorder was made. He was started on amitriptyline 25 mg and was gradually increased to 50 mg. The patient showed gradual improvement in symptoms after 3 weeks of follow-up.
authors: Departments of Dermatology, The Oxford Medical College, Hospital & Research Center, Yadavanahalli, Bangalore, India; abhineethahosthota@yahoo.com.
authors: Abhineetha
authors: A
authors: Hosthota
authors: Psychiatry, The Oxford Medical College, Hospital & Research Center, Yadavanahalli, Bangalore, India.
authors: Swapna
authors: S
authors: Bondade
authors: Departments of Dermatology, The Oxford Medical College, Hospital & Research Center, Yadavanahalli, Bangalore, India.
authors: Divya
authors: D
authors: Monnappa
authors: Psychiatry, The Oxford Medical College, Hospital & Research Center, Yadavanahalli, Bangalore, India.
authors: Vinay
authors: V
authors: Basavaraja
mesh_terms: D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D005114:Extramarital Relations / Q000523:psychology*; D005832:Genital Diseases, Male / Q000523:psychology*; D006167:Guilt; D006801:Humans; D008297:Male; D012611:Scrotum / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline