Giant Molluscum Contagiosum in an HIV-Positive Patient – A Case with Unusual Presentation and Review of Diagnostic Modalities

Abstract

Molluscum contagiosum (MC) is a benign cutaneous viral infection caused by the MC virus belonging to the poxviridae family. The disease is self-limiting in immunocompetent individuals, while it is severe and prolonged when associated with Human Immunodeficiency Virus infection. Dermoscopic examination shows the presence or absence of an orifice and the vascular pattern of vessels. Henderson-Patterson bodies on histopathology, representing intracytoplasmic assemblies of the virus, are pathognomonic. Here, we present a 33-year-old unmarried male with extensive papulonodular lesions over the face, genitals, and groin, for 6 months. Dermoscopy, cytology, and histopathology were consistent with MC. His CD4 count was 9 cell/cu.mm, and HIV-1 and 2 antibodies were reactive. Thus, the diagnosis of giant MC was confirmed, and he was started on anti-retroviral therapy, cryotherapy, and topical imiquimod 5% cream over the lesions.