Molluscum Contagiousum

A 35-year-old female presented with asymptomatic skin lesions on her abdomen, the first of these lesions was noticed three months ago. Since then, the lesions continued to increase in number and size but had remained localized to the area. She had an open cholecystectomy for gallstones at another medical facility, about a month prior to noticing these lesions. There was no family history of similar skin lesions. Clinical examination revealed multiple dome-shaped papules distributed around the scar of a transverse incision in the right hypochondrium. Most of these lesions were around 1 to 5 mm in diameter with a shiny surface, whereas some of the lesions had a clear central indentation (Figure 1). There was no inflammation. A diagnosis of molluscum contagiosum was established on visual inspection. Molluscum contagiosum is a poxvirus infection seen mostly in children, although it can affect any age group [1]. The virus only infects humans and spreads via direct skin to skin contact through contact sports as well as by sharing of towels etc [2]. Figure 1 highlights that the patient possibly acquired this infection during the perioperative period. The anatomical location of the skin lesions as well as the time period between the surgery and the onset of skin disease is consistent with this hypothesis. The average incubation period for molluscum contagiosum is generally two to six weeks and the virus can also be uncommonly transmitted from surgeon to patients [3, 4].

1. Chen X, Anstey AV, Bugert JJ. Molluscum contagiosum virus infection. Lancet Infect Dis2013; 13:877-88. 2. McCollum AM, Holman RC, Hughes CM, Mehal JM, Folkema AM, Redd JT, et al. Molluscum contagiosum in a pediatric American Indian population: incidence and risk factors. PLoS One2014; 9:e103419. 3. Braue A, Ross G, Varigos G, Kelly H. Epidemiology and impact of childhood molluscum contagiosum: a case series and critical review of the literature. Pediatr Dermatol 2005; 22:287-94. 4. Gottlieb SL, Myskowski PL. Molluscum contagiosum. Int J Dermatol 1994; 33:453-61.