Clinical history:

A 70-year old retired worker had more than ten years of skin rash followed up in a skin clinic for management. He accidentally discovered multiple nodules over his scrotum in the past one year and became anxious because he was worrying about skin cancer or infection spreading to other regions. Occasionally, there was some discharge from these lesions and they were itchy to various degrees in the past one year. However, there was no generalized pruritus. There had been one episode of painful swelling in one of these lesions two months ago which responded rapidly to a course of systemic cloxacillin.