Red Scrotum Syndrome Treatment with Pregabalin: A Case Series

Red scrotum syndrome (RSS) (also known as male genital dysesthesia) is a rarely recognized entity characterized by scrotal erythema accompanied by a burning sensation, pain, hyperesthesia/dysesthesia, increased temperature and pruritus. Although its physiopathology is unknown, it has increasingly been associated with chronic topical steroid use in the male genital area. Treatment is challenging and no standardized treatment is currently available. Because current treatment relies on case reports and small case series, the need for more information about drug efficacy in RSS is warranted. The aim of this study is to describe the therapeutic response to pregabalin in patients from an outpatient dermatologic clinic in a tertiary-care hospital diagnosed with RSS. Five patients with a confirmed diagnosis of RSS were included. Ages ranged from 28 to 63 years. All patients had chronic steroid use in the genital area, mostly in the form of combined formulations of corticosteroids, antifungals, and antibiotics. Four patients were prescribed pregabalin monotherapy, 150 mg once daily at night. One patient was prescribed pregabalin and doxycycline. Two patients had complete remission after one month of therapy, one at two months and two at three months. None experienced recurrence at an average of 9.4 months’ follow-up. One patient experienced morning drowsiness that did not require suspending treatment. Pregabalin is a well-tolerated and effective treatment for RSS. (Ann Dermatol 31(3) 320∼324, 2019)