Disfiguring molluscum contagiosum in a HIV-positive patient responding to antiretroviral therapy

Abstract

Molluscum contagiosum (MC) is caused by a double stranded DNA virus belonging to the pox virus family. MC lesions are usually pearly, dome shaped, small, discrete lesions with central umbilication. In HIV-positive patients atypical varieties are found. They may be large or nonumbilicated. Individual papules may join to form the agminate variety. This form is rare. Lesions of MC in healthy immunocompetent patients may occur at any part of the body including face, trunk, and limbs. Sexually active adults have lesions usually on the genitalia, pubis, and inner thigh, rarely on the face and scalp. We present a case of agminate MC occurring in a patient with acquired immunodeficiency disease responding to highly active antiretroviral therapy.

Linear Congenital Molluscum Contagiosum on the Coccygeal Region

“…Plaque formation has been reported as an “agminate” form . Although some cases of agminated molluscum contagiosum that developed in immunocompromised hosts with malignant lymphoma or human immunodeficiency virus infection have been reported, our patient and her parents were healthy.…”

Giant molluscum contagiosum with granulomatous inflammation and panniculitis: An unusual clinical and histopathological pattern in an HIV seropositive child

“…[8] Presence of molluscum contagiosum may herald advancing immunosuppression or very occasionally immune reconstitution. [9] In our patient, the temporal association of occurrence of the molluscum after the initiation of ART, the rapid increase in size of the lesion and presence of granulomatous infiltrate did lead us to consider the possibility of immune reconstitution inflammatory syndrome.…”

UK national guideline for the management of Genital Molluscum in adults, 2014 Clinical Effectiveness Group, British Association for Sexual Health and HIV

“…Where HIV-positive patients with molluscum infection are immunosuppressed, and have extensive lesions, the introduction of effective ART will speed resolution, 81,161–165 (Level IV, C) though there may be an occasional flare-up during immune reconstitution. 82–84…”