Molluscum Dermatitis and its Related Reactions
Year: 2025
Type: article
Abstract: Dear Editor, A 12-year-old girl child was brought to the dermatology department with the chief complaint of elevated whitish lesions over the extremities and trunk for 1 year. On examination, we found pearly white papules with central umbilication over the trunk and upper extremities. Clinically we had diagnosed it as molluscum contagiosum (MC) and given topical tretinoin (0.05%) cream to be applied with a toothpick once daily. After 1 month, the patient came in complaining of itching with a reddish color change of the lesions. On examination, we noticed perilesional erythema and edema of all molluscum lesions of size ranging from 0.5 mm × 0.4 mm to 1 cm × 1.1 cm present in a linear fashion showing the pseudo-Koebner’s phenomenon over the volar aspect of the left forearm [Figure 1]. Larger lesions showed more perilesional erythema with mild scaling and crusting at the center. Trunk lesions showed small papules surrounding the dermatitis [Figure 2]. There was no history of atopy, and the child was seronegative. We diagnosed it as molluscum dermatitis and prescribed 3 days of topical steroid and daily moisturizer for 1 month. MC is a viral infection caused by a pox virus, MC virus. Most of the lesions resolve spontaneously within 2 months, but they may persist for 3–5 years. Few reaction patterns are associated with the healing of lesions. Molluscum dermatitis, or eczema molluscatum, is seen in around 9%–47% of people where the papule develops a dermatitis around it due to a type IV hypersensitivity or id reaction to the virus. It is considered the “beginning of the end” sign, which results in the resolution of lesions due to local cell-mediated immune reaction. The opposite is also true, meaning that when the lesion is removed, the dermatitis resolves.[1–3] A variety of ablative techniques, such as chemical or mechanical removal, are available for treatment. Among chemical methods, topical potassium hydroxide, podophyllotoxin, trichloroacetic acid, salicylic acid, lactic acid, glycolic acid, benzoyl peroxide, and tretinoin are common. Immunomodulators such as oral cimetidine and imiquimod 5% cream are used commonly.[4] The mechanism of action is to induce local irritation, which destroys the viral protein-lipid membrane. Other reactions related to MC are inflamed molluscum[5] and Gianotti–Crosti-like eruptions (GCLEs)[2] [Table 1]. Inflammatory MC lesions and GCLEs are T-cell-mediated immune responses which lead to autoviral clearance of the affected MC, but in the case of molluscum dermatitis, treatment is required.Figure 1: Multiple erythematous papules with central umbilication showing perilesional erythema, size ranging from 0.5 mm × 0.4 mm to 1 cm × 1.1 cm present in a linear fashion over the volar aspect of the left forearmFigure 2: Trunk lesions showing erythema and dermatitis surrounding the molluscum lesionsTable 1: Differentiating features of molluscum dermatitis and related reactionsDeclaration of consent The authors certify that they have obtained all appropriate consent forms, duly signed by the parent(s)/guardian(s) of the patient. In the form, the parent(s)/guardian(s) has/have given his/her/their consent for the images and other clinical information of their child to be reported in the journal. The parents understand that the names and initials of their child/children will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Authors: Diptiranjani Bisoyi, Sujeet Kumar Singh, Manoj Kumar Ram, Tapan Kumar Sethi
Institution: Sriram Chandra Bhanja Medical College Hospital
Language: English
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W4411520038