Trichilemmal Cysts of the Scrotal Wall

A 22-year-old man presented with multiple trichilemmal cysts on the left side of his scrotum, which were painless but unsightly. Ultrasound imaging revealed at least 15 well-defined cysts, ranging from 1 to 2.7 cm in size, with increased blood flow in the surrounding scrotal wall. The cysts were avascular, and the patient exhibited a varicocele upon performing the Valsalva maneuver. Treatment involved administering a broad-spectrum antibiotic, but due to the lack of improvement, a debridement procedure was necessary. The case highlighted the effectiveness of ultrasound in diagnosing and assessing the extent of scrotal cysts and emphasized the importance of prompt treatment to prevent complications such as Fournier's gangrene.