{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:08:34Z","timestamp":1780463314073,"version":"3.54.1"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Genital elephantiasis is a rare but debilitating condition characterized by progressive enlargement due to chronic lymphatic dysfunction. While most commonly associated with filarial infection, secondary causes include malignancy, trauma, surgery, and chronic inflammatory conditions. Scrotal involvement secondary to hidradenitis suppurativa is exceedingly rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a 34-year-old male with long-standing, treatment-refractory hidradenitis suppurativa involving the groin, axilla, and chest, presenting with progressive massive scrotal enlargement over several years. Physical examination revealed a firm, non-tender scrotal mass measuring 20\u202f\u00d7\u202f16\u202f\u00d7\u202f6\u202fcm. Laboratory investigations were within normal limits. The patient underwent complete surgical excision of the scrotal mass via en bloc resection with preservation of both testes and spermatic cords, followed by reconstruction with split-thickness skin grafting of the penile shaft. The resected specimen weighed approximately 6\u202fkg. Histopathology demonstrated reactive fibromyxoid changes without evidence of malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Scrotal elephantiasis secondary to hidradenitis suppurativa is an exceptionally rare complication reflecting advanced lymphatic destruction. Early recognition and timely surgical intervention are essential to restore function and quality of life. This case highlights that even biologic therapy may not prevent progression to end-stage lymphatic disease in refractory HS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1867933","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:47:46Z","timestamp":1780462066000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Scrotal elephantiasis secondary to hidradenitis suppurativa: a rare case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Salem K.","family":"Qupp","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iyad M.","family":"Halayqa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad M.","family":"Zeidan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layth","family":"Al-Karaja","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed F. I.","family":"Alzeer Alhousseini","sequence":"additional","affiliation":[{"name":"Rafidia Governmental Hospital","place":["Rafidia, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.urology.2004.08.051","article-title":"Giant scrotal elephantiasis","volume":"65","author":"Kuepper","year":"2005","journal-title":"Urology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1258\/095646206775809150","article-title":"Genital elephantiasis and sexually transmitted infections revisited","volume":"17","author":"Gupta","year":"2006","journal-title":"Int J STD AIDS"},{"key":"ref3","first-page":"809","article-title":"Scrotal elephantiasis: a review","volume":"148","author":"Weiss","year":"1984","journal-title":"Am J Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1111\/j.1468-3083.2009.03356.x","article-title":"Hidradenitis suppurativa","volume":"23","author":"Revuz","year":"2009","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1800","DOI":"10.21037\/gs-20-460","article-title":"Surgical reconstruction of massive scrotal lymphedema associated with hidradenitis suppurativa: a case report","volume":"10","author":"Yu","year":"2021","journal-title":"Gland Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1016\/j.jaad.2009.08.011","article-title":"Scrotal elephantiasis secondary to hidradenitis suppurativa","volume":"64","author":"Good","year":"2011","journal-title":"J Am Acad Dermatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e70269","DOI":"10.1111\/exd.70269","article-title":"The multifaceted role of keratinocytes in hidradenitis suppurativa pathogenesis","volume":"35","author":"Moltrasio","year":"2026","journal-title":"Exp Dermatol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1016\/S0140-6736(24)02475-9","article-title":"Hidradenitis suppurativa","volume":"405","author":"Sabat","year":"2025","journal-title":"Lancet"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1093\/bjd\/ljad345","article-title":"Hidradenitis suppurativa: new insights into disease mechanisms and an evolving treatment landscape","volume":"190","author":"Krueger","year":"2024","journal-title":"Br J Dermatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1002\/iju5.12245","article-title":"Successful surgical resection and reconstruction of scrotal elephantiasis","volume":"4","author":"Hattori","year":"2020","journal-title":"IJU Case Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"265","DOI":"10.4103\/0974-7796.152945","article-title":"Scroto-perineal hidradenitis suppurativa complicated by giant scrotal elephantiasis","volume":"7","author":"Alharbi","year":"2015","journal-title":"Urol Ann"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1867933\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:47:56Z","timestamp":1780462076000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1867933\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":11,"alternative-id":["10.3389\/fmed.2026.1867933"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1867933","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,3]]},"article-number":"1867933"}}