Scrotal peeling and itching are typically evaluated in the dermatology department for primary skin conditions， or in the urology department if there are concurrent urinary symptoms or urological abnormalities.
一、 Dermatological conditions： These primarily include eczema (atopic dermatitis)， contact dermatitis from irritant/allergen exposure (e.g.， new laundry detergent)， and seborrheic dermatitis. Key symptoms include redness， dry/watery scaling， and intense pruritus. Risk factors include family history of eczema， frequent skin contact with harsh chemicals， or obesity. Special populations： Infants may develop scrotal involvement with diaper dermatitis； adults with atopic tendencies should avoid synthetic fabrics and excessive sweating. It is recommended to seek dermatological evaluation if symptoms persist >1 week without improvement.
二、 Fungal infections (Tinea Cruris)： Caused by dermatophytes (e.g.， Trichophyton rubrum)， these often present as well-defined scaly red patches in the groin， extending to the scrotum. Transmission occurs via direct contact with infected individuals or shared items. Risk factors include warm/humid climates， prolonged sitting， and wearing tight underwear. Special populations： Males aged 15–45 are at higher risk due to increased physical activity and sweat retention； diabetics may have prolonged recovery. Clinical signs like central clearing of the rash and pruritus at night suggest fungal etiology， requiring anti-fungal assessment.
三、 Urological or secondary infectious causes： These involve balanitis (glans penis inflammation with scrotal spread)， folliculitis (infected hair follicles)， or secondary bacterial infections from scratching. Symptoms may include painful urination， penile discharge， or pustular rashes. Risk factors include uncircumcised status， prior UTIs， or poor hygiene. Special populations： Uncircumcised males have higher susceptibility due to retained smegma； children with scrotal hair follicle irritation need prompt urological follow-up if fever or discharge occurs. Urological consultation is advised for persistent symptoms beyond 3 days.
四、 Allergic or non-infectious etiologies： Allergic reactions to hygiene products (e.g.， fragranced soaps) or latex condoms can cause contact dermatitis with scaling. Chronic conditions like scabies (contagious mite infestations) present with linear burrows and severe pruritus. Risk factors include frequent chemical exposure， close contact with infested individuals， or pre-existing skin barrier issues. Special populations： Children in communal settings (daycares) are prone to scabies transmission； elderly with limited mobility may neglect hygiene. Non-pharmacological interventions like barrier creams and scabies isolation are prioritized for these cases.
