Pacheco YD, García-Duque O, Fernández-Palacios J

Language: Spanish
References: 12
Page: 84-88
PDF size: 298.74 Kb.

ABSTRACT

Lymphedema is the result of an alteration of the lymphatic drainage, and its most common worldwide cause is filariasis. In our practice usually is associated to neoplasic, inflammatory and granulomatous processes, radiotherapy, hydroelectrolytic disbalances, and idiopathic. It can affect any part of the body, including the penis and scrotum. The genital lymphedema is a rare presentation, it corresponds to 0.6% of lymphedema. However, causes serious functional, social and emotional limitations for the patient. Too often have pain, recurrent infections, sexual dysfunction, cosmetic deformity, sometimes it limits mobility and ambulation. Although there are several treatment options, both medical and surgical, it has not been found ideal for this disease. We present a 43 years old patient with penoscrotal lymphedema due to hidradenitis suppurativa, it limits his normal activity. The patient was referred to our center after unsuccessful medical treatment (doxycycline and clindamycin cycles). Surgical treatment consisted of total excision of the skin and subcutaneous tissue to Buck’s fascia. Split thickness skin grafts were used to cover the defect. The result was satisfactory both functionally and aesthetically.

REFERENCES

1. Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366:158-64.

2. Jemec GB, Heidenheim M, Nielsen NH. The prevalence of hidradenitis suppurativa and its potential precursor lesions. J Am Acad Dermatol. 1996;35:191-4.

3. Vazquez BG, Alikhan A, Weaver AL, et al. Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. J Invest Dermatol. 2013;133:97-103.

4. Recalde-Losada C, Rubio-Verdú R, Solesio Pilarte F, et al. Abordaje quirúrgico de la elefantiasis escrotal, a propósito de dos casos graves. Cir Plast Iberolatinoam. 2014;40:205-12.

5. Schook C, Kulungowski A, Greene A, et al. Male genital lymphedema: clinical features and management in 25 pediatric patients. J Pediatr Surg. 2014;49:1647-51.

6. Dandapat MC, Mohapatro SK, Patro SK. Elephantiasis of the penis and scrotum. A review of 350 cases. Am J Surg. 1985;149:686-90.

7. García-Tutor E. Tratamiento quirúrgico del linfedema peneano secundario a hidrosadenitis supurativa. Actas Urol Esp. 2005;29:519-22.

8. Chéliz G, Belinki J, Kogan D, et al. Linfedema crónico genital. Plástica reconstructiva. Rev Arg Urol. 2004;69:181-3.

9. McDougal WS. Lymphedema of the external genitalia. J Urol. 2003; 170:711-6.

10. Feins NR. A new surgical technique for lymphedema of the penis and scrotum. J Pediatr Surg. 1980;15:787.

11. Halperin TJ, Slavin SA, Olumi AF, et al. Surgical management of scrotal lymphedema using local flaps. Ann Plast Surg. 2007;59:67-72.

12. Malloy TR, Wein AJ, Gross P. Scrotal and penile lymphedema: surgical considerations and management. J Urol. 1983;130:263-5.