Zenman1

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Oct 31, 2013
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Psychologist is sending me a Soldier who started scratching his balls almost constantly, to the point they are bleeding. His wife is about to leave him over this. He does have some TBI also. Psychologist was excited telling me about him as she loves interesting cases, "I hope you can look up a drug for him!" Yeah, I have some drugs for him! Anyone else have patient doing the same?
 

splik

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well you cant just drug this without knowing the cause! otherwise you might as well refer for castration. differential includes compulsive excoriation, delusional parasitosis, crabs, HSV, restless genital syndrome, medication or drug withdrawal, scrotal dermatitis, intertrigo (i.e. jock itch), lichen simplex chronicus etc
 

wolfvgang22

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Nope, no experience with compulsive scrotal scratching. But if it turns out to be a compulsory behavior or delusions/psychosis and not scabies or something physical, I'd treat it like other similar compulsions or psychotic disorders. I hope he just has scabies.
 

PistolPete

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Maybe you should tell the psychologist that you'll just go straight to ECT? No more ball scratching then.
 

MacDonaldTriad

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I wouldn't suggest bright light therapy in this case, but you could pioneer trans-scrotal magnetic stimulation. Just make sure you ask about metal objects. Seriously, make sure derm sees him before you assume this is psychogenic. Given his wife's reaction, this is probably fairly new behavior.
 

thoffen

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All of this hassle when a simple pair of gloves could fix everything.
 
OP
Zenman1

Zenman1

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Oct 31, 2013
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Looks like Excoriation disorder. TBI PA checked his package, not my job, and said package was ok, just wrinkled, lol! Poor guy has 4 combat deployments so I'd be holding on to my package also. Been doing it after last mortar blast rang his bell. He realizes it's a really a nutty thing to do (pun intended) but it relieves his anxiety. Started him on Zoloft since he has PTSD. Yes, he shook my hand....
 

wolfvgang22

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Just remember, every hand you shake has touched genitals at least once that day. ;)
I hope your patient makes a speedy recovery from PTSD.
 

birchswing

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Does this mean Al Bundy had PTSD?