Atypical infantile genital Molluscum contagiosum

Abstract Genital molluscum contagiosum is rare in children. We report a molluscum contagiosum around the vulva and anus of 9-year-old girl, which has atypical presentations and was finally confirmed by histopathological and electron microscopy findings.

Scanning electron microscopy of molluscum contagiosum* / Microscopia eletrônica de varredura do molusco contagioso

Molluscum contagiosum is a disease caused by a poxvirus. It is more prevalent in children up to 5 years of age. There is a second peak of incidence in young adults. In order to examine its ultrastructure, three lesions were curetted without disruption, cut transversely with a scalpel, and routinely processed for scanning electron microscopy (SEM). The oval structure of molluscum contagiosum could be easily identified. In its core, there was a central umbilication and just below this depression, there was a keratinized tunnel. Under higher magnification, a proliferation similar to the epidermis was seen. Moreover, there were areas of cells disposed like a mosaic. Under higher magnification, rounded structures measuring 0.4 micron could be observed at the end of the keratinized tunnel and on the surface of the lesion.

Molusco contagioso é uma dermatovirose causada por um poxvírus, sendo mais prevalente em crianças com até 5 anos de idade. Um segundo pico de incidência é encontrado em adultos jovens. Com o objetivo de demonstrar sua ultraestrutura três lesões foram curetadas sem rompê-las, cortadas transversalmente e processadas de rotina para microscopia eletrônica de varredura. A estrutura oval do Molusco contagioso pôde ser facilmente observada, no seu centro há uma umbilicação central e logo abaixo observa-se um túnel queratinizado. Com aumentos progressivos observam-se proliferações semelhantes à epiderme e áreas de células dispostas em mosaico. Com grandes aumentos estruturas arredondadas medindo 0,4 micron são vistas no final do túnel queratinizado e na superfície da lesão.

Padrões dermatoscópicos do molusco contagioso: estudo de 211 lesões confirmadas por exame histopatológico / Dermoscopic patterns of molluscum contagiosum: a study of 211 lesions confirmed by histopathology

FUNDAMENTOS: Embora de fácil diagnóstico, o molusco contagioso pode apresentar-se como lesões inflamadas, únicas ou pequenas de difícil diagnóstico. OBJETIVO: Descrever características dermatoscópicas do molusco contagioso e comparar achados do exame clínico e dermatoscópico. MÉTODOS: Avaliou-se clínica e dermatoscopicamente lesões confirmadas pela histopatologia em 57 pacientes. RESULTADOS: Nos exames clínico e dermatoscópico de 211 lesões, foram visualizados orifícios em 50,24 por cento e 96,68 por cento das lesões e vasos em 6,16 por cento e 89,10 por cento delas, respectivamente. Os padrões vasculares encontrados em 188 lesões que apresentaram vasos à dermatoscopia foram coroa (72,34 por cento), radial (54,25 por cento) e puntiforme (20,21 por cento). Metade das 188 lesões apresentou padrão vascular combinado, sendo o padrão em flor (novo padrão vascular) responsável por 19,68 por cento. Foram identificados mais orifícios e vasos no exame dermatoscópico que no clínico, inclusive naquelas com inflamação, eczema perilesional e de tamanho pequeno. Vasos puntiformes relacionaram-se com inflamação, escoriação e eczema perilesional. CONCLUSÕES: A dermatoscopia das lesões de molusco mostrou-se superior ao exame dermatológico mesmo quando seu diagnóstico clínico torna-se difícil. A presença de orifícios, vasos e padrões vasculares específicos auxilia no seu diagnóstico e na diferenciação de outras lesões de pele.

BACKGROUNDS: Although easily diagnosed, molluscum contagiosum may present as a single lesion or as several small, inflamed lesions of difficult diagnosis. OBJECTIVE: To describe the dermoscopic characteristics of molluscum contagiosum and to compare the findings from clinical examination and dermoscopy. METHODS: Histopathologically confirmed lesions were evaluated clinically and dermoscopically in 57 patients. RESULTS: At clinical examination and dermoscopy of 211 lesions, orifices were visualized in 50.24 percent and 96.68 percent of the lesions, and vessels in 6.16 percent and 89.10 percent, respectively. The vascular patterns found in the 188 lesions in which vessels were found at dermoscopy were the crown (72.34 percent), radial (54.25 percent) and punctiform patterns (20.21 percent). Half of the 188 lesions had a combination of vascular patterns, with the flower pattern (a new vascular pattern) being found in 19.68 percent of cases. More orifices and vessels were identified at dermoscopy than at clinical examination, including cases with inflammation or perilesional eczema and small lesions. Punctiform vessels were associated with inflammation, excoriation and perilesional eczema. CONCLUSIONS: Dermoscopy performed on molluscum contagiosum lesions proved superior to dermatological examination even in cases in which clinical diagnosis was difficult. The presence of orifices, vessels and specific vascular patterns aids diagnosis, including differential diagnosis with other types of skin lesion.

Solitary giant molluscum contagiosum presenting as lid tumor in an immunocompetent child.

We report the case of a three-year-old male child who presented with a single painless subcutaneously located upper lid mass of 1.2 × 1.5 cm with a central depression. The mass could be easily separated from overlying skin on complete excision biopsy and showed a never described before whitish brain like appearance consisting of multiple lobes and gyri, which histopathologically proved to be molluscum contagiosum (MC). Tests to investigate underlying immunodeficiency did not show any evidence of immunocompromised state.

Infección por molusco contagioso en pezón: a propósito de un caso / Molluscum contagiosum infection: a purpose of a case

El molusco contagioso es una infección viral que produce lesiones en piel y mucosas características más frecuentes en niños, sin embargo, en el adulto su aparición en el área genital y sitios inusuales, lo cataloga como enfermedad de transmisión sexual. Paciente femenino de 25 años, acude a la consulta por nódulo doloroso en pezón de mama derecha de tres meses de evolución. Antecedentes familiares: dos tías paternas diagnosticadas con cáncer de mama. Al examen físico: área descamativa en areola entre R11-R1 y nódulo doloroso de 4 mm ha dicho nivel, sin signos de flogosis. La ecografía mamaria no reporta lesión. Se realizó la exéresis de nódulo 6 mm blanquecino a través de incisión en base de pezón cuya biopsia reportó infección por molusco contagioso. El molusco contagioso es un virus DNA de la familia de los poxvirus, transmitido por medio de fómites o contacto directo con piel infectada. La lesión típica en piel forma pápulas con umbilicación central de 3 mm a 5 mm de diámetro en tronco, cara y extremidades en los niños, en los adultos en el área genital. Las principales lesiones del pezón son: estructurales, eccematosas, quistes sebáceos e infrecuente los adenomas. Las infecciones del pezón por molusco contagioso son extremadamente raras, así lo demuestra la revisión de casos. La importancia del diagnóstico radica en el control local para reducir contagiosidad, sin embargo, en individuos inmunocompetentes tiene un curso auto limitado.

The molluscum contagiosum is viral infection that produces characteristics papular eruptions in skin and in the mucous membranes. Is more prevalent in children’s although in the adults can infected the genital area, for that reason is knows as a sexual transmitted disease. A 25 years old female patient who referred us painful nodule in her right nipple, the apparition of this nodule was observed three months ago. The familiar antecedents in this patient were: Two paternal aunties with diagnosis of breast cancer. In the physical examination we found: In the scale area between radial 11 and 1 of the areola a 4 mm size painful nodule at the same level. The breast ultrasound study was normal. The lesion excision was made through nipple incision and the biopsy reports: Molluscum contagiosum infection. The molluscum contagiosum is a DNA virus of the poxvirus family; the transmission requires a direct contact with infected hosts or for the contaminated fomites. The common lesion found is self limited 3 mm to 5 mm with papular eruptions in the skin with central umbilicated surface in face, body and in the extremities in children’s and in genitalia in the adults patients. The main nipple lesions are: Structural abnormalities, eczema, sebaceous cysts and uncommon adenomas. The nipple molluscum contagiosum infections are extremely rare. It is important make the diagnosis for the reduction of the transmissibility, and although is self limited in immunocompetents individuals.

A case of molluscum contagiosum.

Molluscum contagiosum is a benign contagious disease caused by a poxvirus. The virus proliferates within keratinocytes and forms intracytoplasmic Molluscum bodies. Though it is a common clinical condition, histologically is not yet reported from this region of Mymensingh. We received a skin biopsy specimen in a pathology laboratory for histological examination. The Haematoxylin and Eosin stained sections revealed typical intracytoplasmic Molluscum bodies in keratinocytes. The lesions were in the trunk, which is a common site for Molluscum Contagiosum (MC). As the diagnosis of Molluscum contagiosum is easy by histological examination, every patient suspected to be this disease is recommended to be examined histologically to exclude other similar types of lesions.

Molluscum contagiosum-like lesions in lepromatous leprosy.

A 23-year old male presented with multiple, asymptomatic, raised lesions of 4 months' duration. The lesions were well demarcated. Dome-shaped papules and nodules were seen on normal looking skin; some were shiny, pearly white and umbilicated. Bilateral greater auricular, ulnar, radial cutaneous and lateral popliteal nerves were thickened. Slit skin smear from an umbilicated nodule had a BI of 6+. Biopsy showed features of lepromatous leprosy.

Dermatoses do pavilhäo auricular / External ear dermatosis

Apresentamos uma atualizaçäo sobre as dermatoses que ocorrem no pavilhäo auricular. Propomos uma classificaçäo em sete grupos e realizamos uma sucinta descriçäo clínica de cada uma das 84 entidades catalogadas, de forma didática, com a finalidade de auxiliar o médico, sobretudo o clínico geral, o dermatologista e o otorrinolaringologista, no diagnóstico de tais patologias.

Molusco contagioso gigante e síndrome da imunodeficiência adquirida: relato de caso / Giant molluscum contagiosum and acquired immunodeficiency syndrome: a case report

Molusco contagioso é uma afecçäo cutânea encontrada em cerca de 5 a 18 por cento dos pacientes portadores do Virus da Imunodeficiência Humana (HIV), nos quais ele assume caráter atípico, e guarda relaçäo com mau prognóstico da infecçäo pelo HIV. Relataremos um caso desta moléstia em uma mulher de 31 anos, ressaltando seus aspectos clínicos, epidemiológicos e imunológicos

Molusco contagioso con halo hipocrómico. Presentación de un caso / Molluscum contagiosum with hypochromic halo. Presentation of a case

Se presenta el caso de un hombre de 57 años con múltiples neoformaciones perladas de 1 a 3 mm, umbilicadas, asintomáticas, rodeadas de un halo de hipopigmentación. El estudio histopatológico mostró inclusiones intracitoplasmáticas en las células epidérmicas y ausencia del pigmento melánico en la periferia

Molusco contagioso: localización en glande / Molluscum contagiosum: unusual localization

El molusco contagioso es una enfermedad infectocontagiosa causada por un poxvirus. Se trata de una dermatosis viral común, cuyo curso clínico reviste carácter benigno. Capaz de comprometer la piel en cualquier territorio corporal, la localización en mucosas es sumamente infrecuente, habiéndose encontrado en la literatura mundial consultada un solo caso aislado en mucosa oral. Su incidencia es mayor en los niños, predominando en el sexo masculino en este grupo etario. Cuando afecta a los adultos, suele revestir el carácter de enfermedad de transmisión sexual, localizándose en la piel de los genitales externos. Puede desarrollarse en pacientes inmunocompetentes y/o en inmunodeprimidos, manifestándose en este último caso como formas diseminadas y/o por localizaciones poco comunes. Presentamos un caso de molusco contagioso situado en glande, de interés clínico por lo atípico de esta localización