Giant Molluscum Contagiosum in an HIV positive patient

Abstract

Molluscum Contagiosum (MC) is a skin infection caused by a double-stranded DNA virus of the family Poxviridae that replicates in the human epidermis, affecting mainly children and young sexually active adults and causing flesh colored papular lesions with central umbilication with an average size of 3-5mm, although atypical lesions that reach great size (Giant Molluscum Contagiosum), 10-15mm, can be seen in almost any immunodeficiency condition. We report the case of a 35 year old male patient with C3 HIV disease with an abdominal pathology associated to skin lesions predominantly in the forehead and scalp that reached sizes over 5mm, diagnosed as Giant Molluscum Contagiosum by skin biopsies.

Isolated giant molluscum contagiosum mimicking epidermoid cyst

“…Molluscum contagiosum (MC) is a common infectious disease of the skin characterized by pearly dome-shaped papules with a central dell or depression located on the face, arms, legs and anogenital region, caused by the molluscum contagiosum virus [1]. The virus replicates in the epidermis and enters the skin from a small skin defect leading to impaired skin barrier function or from contaminated items, such as towels or clothes.…”

“…The virus replicates in the epidermis and enters the skin from a small skin defect leading to impaired skin barrier function or from contaminated items, such as towels or clothes. Specific lesions of MC are usually smaller than 5 mm and less than 20 in number [1–4]. Although it is known to be a disease of childhood, rarely it can be seen in adults.…”

“…Cryotherapy, 10% KOH application, trichloroacetic acid, imiqumod, systemic cimetidin, intralesional 5-FU and bleomycin and total excision are the main treatment options [1,2]. We chose total excision surgery in our patient to exclude epidermoid cyst histologically.…”

“…Molluscum contagiosum is a double-stranded DNA virus, which is the cause of benign, infectious disease of the skin that is characterized by dome-shaped papules with a central dell or depression clinically [1]. In patients with altered or impaired immunity such as atopic dermatitis, after long term corticosteroid and immunosuppressive therapy use, sarcoidosis, leukemias, Wiskott-Aldrich syndrome and especially with acquired immune deficiency syndrome, atypical lesions of molluscum contagiosum may occur, often reaching a large size on an unusual site that can also mimic a wide spectrum of other conditions [2].…”

Lesões Cutâneas Perianais em Doente com Infeção pelo VIH

“…1 A doença é geralmente mais grave nos doentes com infeção pelo VIH e redução marcada dos linfócitos T CD4 + . [1][2][3] Clinicamente podem existir múltiplas lesões típicas (pápulas umbilicadas com menos de 1 cm) e/ou atípicas (mais de 2 cm, confluentes), colocando dificuldades no diagnóstico diferencial com condilomata lata (sífilis secundária) e condilomas acuminados. 4 Embora possa ocorrer resolução espontânea com terapêutica antirretroviral, as lesões podem mostrar-se resistentes e recidivantes.…”