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Clinical Summary

Molluscum contagiosum is caused by a poxvirus that presents flesh-colored, dome-shaped lesions on affected individuals. Usually, molluscum contagiosum is an asymptomatic benign disease but may become severe in HIV patients. Typical presentations consist of groups of 2 to 20 small, discrete, shiny lesions with central umbilication.

Management and Disposition

If the diagnosis is suspected in the ED, the patient should be reassured and referred to a dermatologist. Usually self-limited with spontaneous remission, treatment outside of genital lesions is for cosmetic reasons only.

Pearl

  1. Clinically, it may be difficult to distinguish between cutaneous Cryptococcus and molluscum contagiosum. Dermatology or infectious disease consultation and biopsy may be required if the patient is clinically ill. With ART and immune reconstitution, these lesions generally resolve.

FIGURE 20.37

Molluscum Contagiosum. Facial rash with ocular involvement is a common site of infection in HIV patients. Note the central umbilication. (Photo contributor: Department of Dermatology, National Naval Medical Center, Bethesda, MD.)

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