Molluscum contagiosum — Clinical Case (Wikimedia Commons)

Diagnosis: Molluscum contagiosum

Sans risque pour la santé, le molluscum contagiosum n’est jamais grave, et pas plus chez les enfants que chez les adultes. Il convient simplement de couvrir les boutons avec des vêtements longs ou du . Clinical photograph sourced from Wikimedia Commons (CC BY-SA 4.0). Attribution: Mohammad2018.

Clinical Presentation

Discrete, dome-shaped, flesh-colored to pearly papules with central umbilication (dell). Usually 2-5mm. Distribution: trunk, extremities, face in children; genital area in adults. May develop surrounding eczematous dermatitis (molluscum dermatitis). Extensive in HIV/immunosuppression.

Clinical History

Self-limited in immunocompetent (6-12 months average, may take 2-4 years). Spread by skin contact, swimming, shared towels. Giant molluscum (>1cm) or extensive disease suggests immunodeficiency — check HIV status in adults.

Treatment

Often self-resolving — watchful waiting is appropriate. Destructive: cryotherapy, curettage, cantharidin. Topical: imiquimod (off-label), tretinoin, podophyllotoxin. Extensive/HIV: treat underlying immunodeficiency, cidofovir for refractory cases.

Differential Diagnosis

Verruca, Folliculitis, Milia, Basal cell carcinoma (solitary), Cryptococcosis (in HIV), Histoplasmosis (in HIV)

Key Learnings

Central umbilication is the key diagnostic feature. DOIA (dermatitis of immunocompromise with atypical features) — extensive molluscum in adults warrants HIV testing. Cantharidin is effective but must be applied carefully to avoid blistering.

Tags: molluscum, viral, poxvirus, pediatric, sexually transmitted