Causes and Associated Treatment
The exact cause of these black spots on the scrotum (and all other angiokeratomas) is still unknown, but there are several factors which are thought to be probable causes. The following enumerates the factors, which could have contributed to the development of this scrotal condition:
Increased Blood Vessel Pressure
Medical experts consider an increase in pressure of the blood vessels in the scrotal area as one factor that has the greatest potential to cause angiokeratoma of Fordyce. With increased pressure, small cutaneous capillaries on the scrotal area may vasodilate and even rupture; which eventually leads to these small, red, purple, or black spots. Conditions that increase the venous pressure in the scrotal area include: varicoceles, hernias, urinary system tumors and epididymal malignancies. The treatment for this is focused on treating the underlying condition that has caused the increased blood vessel pressure on the scrotum.
Enzyme-linked disorders such as: 1) Fucosidosis, a rare disorder characterized by an alpha-fucosidase enzyme deficiency and 2) GM gangliosidosis type 2, a deficiency of B and C isoenzymes of beta-galactosidase; are also pointed out as possible culprits for angiokeratoma of Fordyce, but to a lesser degree as compared to the former cause. The treatment for this cause is geared on managing the enzyme-linked disorders first. However, for such rare diseases, treatment is usually for the symptoms alone.
Although Anderson-Fabry’s Disease is highly associated with angiokeratoma corporis diffusum, the said condition may also causes black spots or papules to appear on the scrotum. This condition is a genetic disorder that is characterized by a deficiency in an enzyme that breaks down lipids. The treatment for this condition is through medications and enzyme replacement therapy.