Red scrotum syndrome: An update on clinicopathologic features, pathogenesis, diagnosis, and management

J Am Acad Dermatol. 2022 Sep;87(3):614-622. doi: 10.1016/j.jaad.2020.05.113. Epub 2020 Jun 1.


The genital skin may be affected by a variety of dermatoses, be it inflammatory, infectious, malignant, idiopathic, or others. The red scrotum syndrome is characterized by persistent erythema of the scrotum associated with a burning sensation, hyperalgesia, and itching. Its cause is unknown, but proposed mechanisms include rebound vasodilation after prolonged topical corticosteroid use and localized erythromelalgia. The condition is chronic, and treatment is often difficult. Here we review the etiology, the physical and histopathologic findings, and the management of this condition. We also describe related conditions such as red scalp syndrome, red ear syndrome, and red vulva syndrome. Finally, we summarize the different cases reported in the literature and discuss the features that help in the differentiation of red scrotum syndrome from its mimickers.

Keywords: doxycycline; pregabalin; red ear syndrome; red scrotum syndrome; rosacea; topical corticosteroids.

Publication types

  • Review

MeSH terms

  • Erythema / diagnosis
  • Erythema / etiology
  • Erythema / therapy
  • Erythromelalgia*
  • Female
  • Humans
  • Male
  • Scrotum*
  • Skin / pathology
  • Syndrome