What are the diagnostic considerations if molluscum contagiosum is suspected?

Updated: Aug 09, 2018
  • Author: Ashish C Bhatia, MD, FAAD, FACMS; Chief Editor: Dirk M Elston, MD  more...
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Answer

The cutaneous manifestations of other opportunistic infections, such as cutaneous cryptococcosis, histoplasmosis, and aspergillosis, may mimic molluscum contagiosum and must be ruled out in immunocompromised hosts. (See the images below.)

This lesion of cutaneous coccidioidomycosis could This lesion of cutaneous coccidioidomycosis could be included among the differential diagnoses of molluscum contagiosum.
This keratoacanthoma could be included among the d This keratoacanthoma could be included among the differential diagnoses of molluscum contagiosum.

Molluscum contagiosum may be randomly associated with other lesions, such as epidermal cysts, nevocellular nevi, sebaceous hyperplasias, and Kaposi sarcoma. Pseudocystic molluscum contagiosum, giant molluscum contagiosum, and molluscum contagiosum associated with other lesions are responsible for frequent clinical misdiagnoses.

Infection of children through sexual abuse is possible; however, to a greater extent than warts, molluscum contagiosum virus is quite common on the genital, perineal, and surrounding skin of children. [21, 22] Regard abuse as unlikely, unless other suspicious features are present.

Histologic or microscopic confirmation of molluscum contagiosum is indicated in patients who are immunocompromised because several life-threatening opportunistic infections may clinically mimic molluscum contagiosum.


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