How is molluscum contagiosum diagnosed?

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

In most instances, a diagnosis is easily established because of the distinctive, central umbilication of the dome-shaped lesion. Pseudocystic molluscum contagiosum, giant molluscum contagiosum, and molluscum contagiosum associated with other lesions may be more difficult to diagnose clinically.

If diagnosis is uncertain, lesions may be biopsied. Characteristic intracytoplasmic inclusion bodies (molluscum bodies, or Henderson-Paterson bodies) are seen on histologic examination findings.

Express the pasty core of a lesion by crushing the lesion between 2 microscope slides and staining it to reveal the particulate virions, which are present in abundance. Firm compression between the slides is required to release the virions with the stain in place. The use of crystal violet, safranin, and ammonium oxalate in 10% ethanol; the Papanicolaou test; or Wright, Giemsa, or Gram stains can reveal the virions that make up the Henderson-Paterson bodies.

Measure serum antibodies by complement fixation, tissue culture neutralization, fluorescent antibody, and gel agar diffusion techniques; however, they are not well standardized and are seldom used except in research protocols.

Polymerase chain reaction (PCR) assay can be used to detect and categorize molluscum contagiosum virus in skin lesions.

Molluscum contagiosum virus cannot be grown in tissue culture; however, Buller et al demonstrated molluscum contagiosum virus replication in an experimental system using human foreskin grafted to athymic mice. [24]

Evaluate the patient for other sexually transmitted diseases (STDs) because sexually active patients may acquire other concomitant venereal diseases, such as syphilis and gonorrhea. Always consider testing for HIV infection in patients with facial lesions.


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