There are a lot of practice questions on molluscum contagiosum. Although its clinical appearance and histopathology are fairly distinctive, I often confuse this with keratoacanthoma.
- Molluscum contagiosum lesions are dome-shaped, waxy nodules with central umbilication.
- The key histopathologic description for molluscum contagiosum is acanthosis with a central crater. This is nearly identical to the histopathologic description of a keratoacanthoma (acanthosis and hyperkeratosis with a central keratin-filled crater). One of the key differences is the amount of keratin - molluscum lesions do not have keratin in the crater (they have virus particles instead), keratoacanthomas do.
- Molluscum lesions have eosinophilic inclusion bodies, called Henderson-Patterson bodies. They become more and more basophilic as they migrate to the surface.
- Molluscum contagiosum is caused by a poxvirus.
- It can cause a follicular conjunctivitis.
- Multiple molluscum lesions should prompt investigation of an immunocompromised state, especially AIDS.
- Molluscum lesions can be managed by observation, excision, curettage, or controlled cryotherapy.
References and Additional Reading
- Basic and Clinical Science Course, Section 4: Ophthalmic Pathology and Intraocular Tumors. American Academy of Ophthalmology, 2017-2018 edition.
- Basic and Clinical Science Course, Section 7: Orbit, Eyelids, and Lacrimal System. American Academy of Ophthalmology, 2017-2018 edition.
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