History:

 A 28-year-old male presented with asymptomatic dark-blue vascular spongy swelling studded with many compressible papules on the scrotum. The lesions have been present since birth. Profuse bleeding might occur on trauma or hair shaving as the patient claimed. On examination, the surface of the lesions was smooth devoid of any scales.  The main differential diagnoses were: congenital vascular malformation of the scrotum and angiokeratoma of Fordyce (although the lesions are present since birth). Biopsy couldn’t be achieved, however, U/S and Doppler studies showed extensive varicosities of the scrotal wall (see the attached report). So the case is diagnosed as congenital vascular malformation of the scrotum.