A 17-year-old healthy male presented to the emergency room with painful black ulcers on his scrotum that developed acutely over 24-hours. Other symptoms included fatigue, nausea, and vomiting. He had a mild leukocytosis, but was afebrile. He continued to develop new lesions despite initiation of antibiotics at presentation. Workup was negative for herpes simplex virus (HSV), epstein-barr virus (EBV), human immunodeficiency virus (HIV), and Syphilis. A workup was initiated to rule out underlying vasculitis or vasculopathy , this was also negative. A shave-biopsy of an ulcer edge demonstrated an area of dermal necrosis associated with dense neutrophilic inflammation, hemorrhage, and intravascular thrombosis. A diagnosis of Juvenile Gangrenous Vasculitis of the Scrotum (JGVS) was made. He was treated with oral prednisone and immediately stopped developing new ulcers and showed complete resolution after 6 weeks of therapy (Figure 1).
Figure 1. Black Ulcers on Scrotum
![Black Ulcers on Scrotum](https://openventio.org/wp-content/uploads/IMOJ-5-116-Figure-1.png)
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CONFLICTS OF INTEREST
The authors declare that they have no conflicts of interest.