Emerg Med J 23:e57 doi:10.1136/emj.2006.038745
  • Emergency casebook

Angiokeratoma of the scrotum: a case of scrotal bleeding

  1. R Trickett,
  2. H Dowd
  1. University Hospital of Wales, Cardiff, UK
  1. Correspondence to:
 R Trickett
 University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK; ryan{at}
  • Accepted 23 May 2006


A 26-year-old man presented to the emergency department after a spontaneous 30 min bleed from his scrotal skin. He showed no other symptoms and denied any past medical history. He was exclusively sexually active, systemically well and haemodynamically stable. There were numerous (>50) 1–2 mm dark red, erythematous papules over the scrotum, sparing the shaft of penis, inner thigh and abdomen. A small area of blood marked the bleeding spot as a single papule. A diagnosis of angiokeratoma of the scrotum (Fordyce) was made and potential precipitants such as intra-abdominal masses, urinary tract tumours, varicoceles, hernias and angiokeratoma corporis diffusum (Fabry syndrome) were excluded. He was discharged with dermatology follow-up with a view to local laser treatment. The important differential diagnoses are angiokeratoma corporis diffusum and malignant melanoma (nodular type). In females, Fordyce angiokeratoma are distributed on labia majora.


  • Competing interests: None.

  • Informed consent was obtained for publication of the figure.