A novel pinch-and-punch excision technique for removing scrotal calcinosis was recently described.9 This procedure involves initially injecting 0.1% lidocaine with 1:10,000 epinephrine locally. The anesthetic, combined with gently rubbing the cysts, separates the cysts from the surrounding connective tissue and superficial scrotal (Dartos) fascia. After
10 minutes, a 2- to 4-mm disposable biopsy punch is used to incise the skin over the cyst. Small cysts can be removed with forceps, while larger lesions are squeezed out. Any residual cyst wall may be grasped with forceps and pulled out. Suture closure is usually not required, and second-intention healing is enhanced by the contractile nature of scrotal skin.
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