Answer

Giant molluscum in an immuocompetent individual.

Discussion

Molluscum contagiosum (MC) is a common viral infection appearing as solitary or a small group of characteristic flesh colored, translucent papules on face, trunk, genitalia, and other body parts. Increased number of lesions may be seen in malignancies, immunosuppresion due to disease or drugs. ^[1] In patients with acquired immune deficiency syndrome, ^[2] the lesions affect the eyelids, conjunctiva, can be of huge size (10-15 mm) and number and resistant to therapy. MCs of such number, size, and secondary changes are unusual in the immunocompetent individual. Confirmation is by demonstrating enlarged epithelial cell with intracytoplasmic molluscum bodies. Differential diagnoses include folliculitis, warts, keratoacanthoma or cryptococcosis. Treatment modalities include cyotherapy, extirpation followed by cauterization of the base, or chemical cautery. In our patient, surgical excision combined with electro cautery was performed resulting in complete clearance and cosmetic improvement. [Figure 3].

Figure 3: Posttreatment photo Click here to view