# Acute Scrotal Ulcers in a 34-Year-Old Male With an Excellent Treatment Response: A Case Report

## TL;DR

A 34-year-old man with scrotal ulcers was diagnosed with juvenile gangrenous vasculitis and successfully treated with steroids and antibiotics.

## Contribution

This case report expands the known age range for juvenile gangrenous vasculitis of the scrotum.

## Key findings

- The patient showed complete healing after treatment with methylprednisolone and doxycycline.
- The patient had satellite ulcers on the thigh, which is less commonly reported in JGVS cases.
- No microbiologic agents were detected, supporting an autoimmune cause.

## Abstract

Juvenile gangrenous vasculitis of the scrotum (JGVS) is a rare disease, but it has a distinct presentation and a favourable response to treatment. In this clinical case, we present a male patient in his early 30s with tender scrotal ulcers, no history of sexually transmitted diseases or risk behaviours, and no previous systemic disease or immunosuppression. Studies revealed elevated inflammatory markers, but remarkably, all microbiologic studies were negative. The patient was diagnosed with JGVS and was treated with methylprednisolone 24 mg, tapered over two months, in combination with doxycycline 100 mg BID for one month, and topical clobetasol under occlusion, with complete healing in two months and no relapse. This case contributes to the existing knowledge of JGVS. Typically, patients are young, usually under 30 years old; however, this patient was slightly older. While exclusive scrotal involvement is common, this patient also exhibited smaller satellite ulcers on the adjacent thigh.