PMC138815_01
PMC138815_02
Clinical photograph of scrotum: A large necrotic area is visible in the right side of scrotum.
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F2
This increased in size during the course of the next 48 hours. (Figure 2).
Ultrasound of left side of scrotum demonstrated normal left testis and epididymis with normal appearing skin.
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F3
Ultrasound of scrotum, performed on 06 March 2002, demonstrated normal left testis and epididymis, with a normal skin appearance. (Figure 3).
Ultrasound of right side of scrotum: The right testis and epididymis were normal, but the overlying skin was oedematous. The difference in skin thickness between the right and left side of scrotum is obvious when Figure 3 is compared with Figure 4.
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F4
The right testis and epididymis were also normal, but the overlying skin was oedematous. (Figure 4).
Ultrasound of right side of scrotum: There was small amount of fluid collection in the subcutaneous tissue on the right side of scrotum. The appearances were consistent with localised cellulitis.
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F5
There was a small fluid collection in the subcutaneous tissue on the right side of scrotum. (Figure 5).
Histology of excised skin shows full thickness, featureless, coagulative necrosis with no viable tissue remaining (haematoxylin & eosin).
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F6
Histology of excised tissue revealed full thickness coagulative necrosis with no viable skin remaining. (Figure 6).
Histology of excised scrotal skin shows zones of neutrophil polymorph infiltration, with embedded foreign material possibly representing hair shafts (haematoxylin & eosin).
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F7
There were zones of polymorph infiltration; and occasional birefringent material was present, a few of which resembled hair shaft material. (Figure 7).
Histology of excised skin shows bacterial colonies (cocci and bacilli) in the superficial zone (haematoxylin & eosin).
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F8
Colonies of bacteria, both cocci and bacilli, were present on the surface in places. (Figure 8).
PMC138815_03
Clinical photograph of scrotum taken six weeks after the initial photograph (Figure 2): The necrotic skin had been excised. The wound was treated with povidone-iodine spray twice a day. This patient made a good progress with gradual healing of the wound.
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F9
He made a good progress and the wound was healing gradually. (Figure 9).