gms | German Medical Science

Objectives/Interrogation: Molluscum Contagiosum (MC) is a benign and contagious skin infection caused by molluscum contagiosum virus (MCV) of poxvirus family. MC is a self-limiting condition affecting the skin and mucus membrane. It is commonly seen in children of age 2 -5 years, but can be seen in sexually active adults and immunosuppressed individuals. Clinically MC presents with small, discrete, dome shaped papules with central umbilication. The clinical presentation of MC in most cases is diagnostic which can be further confirmed by histopathology examination in cases that are not clinically obvious.

We report a case of MC in an immunocompetent female with atypical clinical presentation and radiological findings which is confirmed by histopathological findings.

Methods: A 36 year old lady presented to our clinic with a painless swelling over the dorsum of her left ring finger since 3 months resulting in difficulty in wearing her finger ring. There was no history of any trauma. The swelling was non-tender, soft in consistency, of approximate size of 6 X 8 mm over the dorso-radial aspect of proximal phalanx of left ring finger.

Routine radiographs were unremarkable, while an MRI revealed a well defined, space occupying lesion of approximately 10 x 8 x 5.5 mm; indicating benign neoplastic lesion, possibly a fibroma.

An excision biopsy was advised.

Results and Conclusions: Histo-pathological examination revealed epidermis of skin lined by lobulated stratified squamous epithelium showing hyperkeratosis, acanthosis, and parakeratosis. A cyst filled with large eosinophilic inclusions infiltrating into the epidermis. Molluscum bodies or colonies of MCV were seen.

This case report is perhaps the first of its kind with a rare presentation of Molluscum Contagiosum in an immunocompetent adult at an unusual location (finger). The MRI was also confounding as was the clinical appearance.

Follow up after 12 months showed no recurrence.