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

Poojary, Shital; Kokane, Priyanka Trimbak

doi:10.4103/0253-7184.156750

Cited by 8 publications

(12 citation statements)

References 12 publications

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“…Granulomatous response may be attributed to rupture and discharge of contents of the molluscum bodies into the dermis. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility and pitfalls of Tzanck smear cytology in diagnosis of various cutaneous lesions

Panwar¹,

Joshi²,

Goel³

et al. 2017

J Cytol

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Aims:Tzanck smear is an old but useful test for diagnosis of cutaneous dermatoses. The aim of this study was to highlight the potential usefulness and diagnostic pitfalls of Tzanck smear for diagnosis of cutaneous dermatoses and infections.Materials and Methods:This hospital based cross-sectional study was carried out on all Tzanck smears received for a period of twenty months (January 2014–August 2015). The smears were assessed to establish the utility of Tzanck smears in corroborating or excluding a diagnosis of immunobullous lesion or herpetic infection. Cases with discrepant diagnosis on histopathology were reviewed to identify additional cytomorphological features.Results:A total of 57 Tzanck smears were performed during the study period. Out of the 18 clinically suspected cases of immunobullous disorders, Tzanck smear findings corroborated the clinical diagnosis in 7/18 cases, one case was diagnosed as cutaneous candidiasis, and diagnosis of immunobullous lesions could be excluded in 5/18 cases. Out of the 19 suspected cases of herpetic infections, viral cytopathic effect was observed in 8/19 cases. Besides immunobullous lesions and herpetic infections, acantholytic cells were also observed in spongiotic dermatitis and genodermatosis. Dyskeratotic keratinocytes seen in vacuolar interface dermatitis were not easily distinguishable from acantholytic cells on Tzanck smear.Conclusions:Tzanck smear test is an inexpensive and useful diagnostic tool for certain skin diseases. It can aid in establishing a rapid clinical diagnosis and can serve as a useful adjunct to routine histological examination. We recommend the use of Tzanck smear as a first-line investigation for vesiculobullous, erosive, and pustular lesions.

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“…Granulomatous response may be attributed to rupture and discharge of contents of the molluscum bodies into the dermis. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility and pitfalls of Tzanck smear cytology in diagnosis of various cutaneous lesions

Panwar¹,

Joshi²,

Goel³

et al. 2017

J Cytol

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“…3 As per study by Pujari Shital et al in 2015 in India, the incidence of MC in HIV infected persons rises from 5% -18% to 25% -35%. 4 Larger lesions of more than 1 cm are called as "Giant molluscum." 5 In the presence of HIV infection, the clinical appearance and the course of MC are atypical and clinical picture differs from the non-HIV population.…”

Section: Discussionmentioning

confidence: 99%

Genital Molluscum Contagiosum and Hiv- A Comparative Study

Balkrishna¹,

J²,

Pratap³

2017

jemds

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BACKGROUND Genital Molluscum (GM) is Sexually Transmitted Disease (STD), common in young adults. Will there be any clinical differences including dissemination with HIV status? So, we compared GM clinically in HIV positive and negative patients. MATERIALS AND METHODS 50 patients of GM, 25 in each group of HIV positive and negative were compared in this observational and prospective study. P value less than i.e. < 0.05 was considered as significant association. RESULTS A: HIV positivity was associated significantly in-a) Age: Higher age group (43 years and 28 years respectively) (p-0.000); b) Trunk (p-0.006); c) Face (p-0.001); d) Giant size (p-0.014); e) Infection or ulceration (p-0.038); B: HIV positivity was not associated with Gender (p-0.254). CONCLUSION Presence of molluscii was associated with HIV positivity with trunk, face, giant size and infection/ulceration, which can be a marker of HIV infection. Gender has no association with HIV infection. Thus, clinical presentation of Genital Molluscum differs with the HIV status of patients. Overall dissemination at multiple sites is common in HIV positive group.

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“…Molluscum contagiosum is frequently associated with HIV infection and acquired immunodeficiency syndrome (AIDS) (Table 3) [30][31][32][33][34][35][36][37]. The onset of HIV-associated molluscum contagiosum range from infancy and early childhood [30,31] to middle-aged adults [36,37].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, in some individuals, molluscum contagiosum may serve as the first clinical indicator of HIV infection [30,35,37]. [30][31][32]34,38]. They can be solitary [32,36] or multiple [30,31,[33][34][35]37].…”

Section: Discussionmentioning

confidence: 99%

Molluscum contagiosum of the eyelid: case report in a man receiving methotrexate and literature review of molluscum contagiosum in patients who are immunosuppressed secondary to methotrexate or HIV infection

Beutler

Cohen²

2016

Dermatology Online Journal

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Background: Molluscum contagiosum is a benign viral infection of the skin. Lesions typically present as dome-shaped, fleshcolored, umbilicated papules that range in size from 1 to 5 millimeters in diameter. They are usually asymptomatic, but can become tender or pruritic. Children and immunocompromised adults, including individuals being treated with immunosuppressive drugs, are most susceptible to infection. Single or multiple lesions most commonly appear on the extremities, face, genitals, and trunk. However, albeit rarely, molluscum contagiosum may also develop at other sites, including the eyelids.Purpose: We describe the clinical and pathologic findings of a man who developed molluscum contagiosum of the eyelid while receiving methotrexate. We also review the characteristics of other patients with molluscum contagiosum acquired either during treatment with methotrexate or associated with human immunodeficiency virus (HIV) infection and summarize the unusual sites of presentation for the viral lesions in these individuals.Materials and methods: The features of a man receiving methotrexate who developed molluscum contagiosum of the eyelid are presented. Using PubMed, the following terms were searched and relevant citations assessed: adalimumab, contagiosum, Enbrel, etanercept, Humira, infliximab, methotrexate, molluscum, Remicade, TNF alpha, and tumor necrosis factor alpha. In addition, the literature on methotrexate treatment and molluscum contagiosum is reviewed.Results: Several small papules were observed on the eyelid of a 24-year-old man who had been receiving methotrexate and adalimumab (Humira) for the treatment of Crohn disease. The lesions were removed by shave biopsy. Microscopic examination revealed epidermal hyperplasia composed of keratinocytes filled with large eosinophilic intracytoplasmic inclusions. Based on correlation of the clinical presentation and histopathologic findings, a diagnosis of molluscum contagiosum was established. The patient applied mupirocin 2% ointment to the biopsy sites, which subsequently healed without complication or recurrence. Conclusion:Molluscum contagiosum is a benign viral papular eruption that frequently affects children and immunocompromised adults. Patients treated with immunosuppressive agents, such as methotrexate, have a heightened risk of developing molluscum contagiosum lesions. It remains to be determined whether adjunct therapy with a tumor necrosis factor alpha inhibitor increases the risk of this viral infection. Diagnosis can usually be established by clinical presentation, although a biopsy is sometimes required to exclude other conditions. Molluscum contagiosum is generally self-limiting and often resolves spontaneously within 18 months. However, topical (cantharidin) or locally destructive (curettage, cryotherapy, and/or laser) therapy may be indicated for patients who are concerned about persistent lesions and for children who are particularly susceptible to autoinoculation.

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

Cited by 8 publications

References 12 publications

Diagnostic utility and pitfalls of Tzanck smear cytology in diagnosis of various cutaneous lesions

Diagnostic utility and pitfalls of Tzanck smear cytology in diagnosis of various cutaneous lesions

Genital Molluscum Contagiosum and Hiv- A Comparative Study

Molluscum contagiosum of the eyelid: case report in a man receiving methotrexate and literature review of molluscum contagiosum in patients who are immunosuppressed secondary to methotrexate or HIV infection

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