The molluscum contagiosum virus may be inoculated along a line of minor skin trauma (eg, from shaving), resulting in lesions arranged in a linear pattern (see the image below). This process, termed autoinoculation, can also result from manipulation of lesions by the patient. Autoinoculation is different from the Koebner phenomenon, which is also called an isomorphic response. In the Koebner phenomenon, new lesions develop along a line of trauma and the etiology of the underlying condition is unknown. Psoriasis and lichen planus are examples of skin conditions that commonly koebnerize.
In a patient who had preexisting molluscum contagiosum, the virus was inoculated along a line of minor skin trauma, resulting in the development of the 3 new lesions.
Molluscum contagiosum virus transmission through direct skin contact between children sharing a bath and between athletes sharing gymnasium equipment and benches has been reported. An association between school swimming pool use and molluscum contagiosum infection has also been reported. [2, 3]
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Note the central umbilication in these classic lesions of molluscum contagiosum.
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Approximately 10% of patients develop eczema around lesions. Eczema associated with molluscum lesions spontaneously subsides following removal.
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Molluscum contagiosum on the shaft of the penis. Molluscum contagiosum in the genital region of adults is most commonly acquired as a sexually transmitted disease.
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Larger lesions may have several clumps of molluscum bodies rather than the more common single central umbilication. This may make them difficult to recognize as molluscum contagiosum.
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Molluscum lesions may become quite numerous in intertriginous areas. This child has autoinoculated lesions to both inner thighs.
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After trauma, or spontaneously after several months, inflammatory changes result in suppuration, crusting and eventual resolution of the lesion. This inflammatory stage does not usually represent secondary infection and seldom requires antibiotic therapy.
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Lesions of molluscum contagiosum have a characteristic histopathology. Lobules containing hyalinized molluscum bodies, also known as Henderson-Paterson bodies, are diagnostic.
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This lesion of cutaneous coccidioidomycosis could be included among the differential diagnoses of molluscum contagiosum.
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This keratoacanthoma could be included among the differential diagnoses of molluscum contagiosum.
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Lesions on the upper eyelid of a 3-year-old child.
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In a patient who had preexisting molluscum contagiosum, the virus was inoculated along a line of minor skin trauma, resulting in the development of the 3 new lesions.
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Molluscum contagiosum on the right axilla.
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Presented here are the classic umbilicated papules of molluscum contagiosum lesions on the cheek of a child. Facial lesions occur frequently in children, although lesions generally are few.
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Molluscum contagiosum rarely occurs on the face in an adult unless the patient is infected with HIV. When molluscum contagiosum occurs in individuals infected with HIV, facial lesions are common and frequently numerous.
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Molluscum contagiosum lesions in individuals infected with HIV may number in the hundreds. In addition, they may become quite large and prominent.
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This low-power view of a molluscum contagiosum lesion shows the classic cup-shaped invagination of the epidermis into dermis. The Henderson-Paterson bodies are identified readily and stained purple to red in this image.
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This is a medium-power view of a molluscum contagiosum lesion. Magnification allows better demonstration of the intracytoplasmic molluscum bodies (staining purple-pink) within the keratinocytes.
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This molluscum contagiosum body is an intracytoplasmic inclusion body. Notice in the image that the keratinocyte nuclei are displaced to the periphery of the cell and that the intracytoplasmic inclusions have a granular quality.
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Multiple papules on the face of a man with HIV.
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Cytoplasmic viral inclusions become progressively larger toward the epidermal surface (hematoxylin and eosin, 200X)
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Low-power histopathologic examination reveals an overall cup-shaped appearance.
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Viral particles have a dumbbell-shaped appearance. Courtesy of Alvin Zelickson, MD.
