Teaching File - Molluscum contagiosum

Diagnosis: Teaching File - Molluscum contagiosum

Case submitted by Shahbaz A. Janjua to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Shahbaz A. Janjua. Originally posted March 10, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Verruca vulgaris • Basal cell carcinoma (small) • Milia • Cryptococcosis (immunocompromised) • Histoplasmosis (immunocompromised) • Folliculitis • Keratoacanthoma

Key Learnings

• Caused by Molluscum contagiosum virus (MCV) — a poxvirus • Pearly, dome-shaped papules with central umbilication are pathognomonic • Self-limited in immunocompetent patients (6-12 months), but may persist for years • Widespread or giant lesions in HIV → check CD4 count • Eczema molluscatum: molluscum in areas of atopic dermatitis • BOTE sign (beginning of the end): surrounding dermatitis/inflammation heralds spontaneous resolution • Histology: Henderson-Patterson bodies (eosinophilic cytoplasmic inclusions)

Tags: teaching, file, molluscum, contagiosum, shahbaz a. janjua