Molluscum Contagiosum — SCE Infectious Diseases MCQ

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EasyHIV MedicineMolluscum ContagiosumSCE Infectious Diseases

A 42-year-old HIV-positive man (CD4 550, viral load <50 on ART) presents with multiple flesh-coloured papules with central umbilication on his face and trunk. A skin biopsy shows Henderson-Patterson bodies. What is the most likely diagnosis?

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Correct answer: D — Molluscum contagiosum

Flesh-coloured umbilicated papules with Henderson-Patterson bodies (large eosinophilic intracytoplasmic inclusion bodies) on biopsy are diagnostic of molluscum contagiosum (caused by molluscum contagiosum virus, a poxvirus). While typically self-limiting in immunocompetent individuals, extensive disease can occur in HIV. The main differential for umbilicated papules in HIV is disseminated cryptococcosis or histoplasmosis, which can appear clinically similar but are distinguished by biopsy findings.

Reference: BHIVA 2022 – Dermatological conditions in HIV; BAD 2023 – Molluscum guidelines