Molluscum contagiosum is usually asymptomatic, although an eczematous,
red, scaling patch may surround lesions in about 10% of patients,
and is termed molluscum dermatitis. Molluscum are
usually diagnosed clinically, based on morphology and distribution.
Flat-topped, discrete, dome-shaped, flesh-colored lesions are usually
1 to 5 mm in diameter. Central white cores or umbilication are seen
in active lesions (Fig. 367-5). Molluscum
lesions commonly occur on the trunk, face, and extremities, but
may be generalized.2 Groups of lesions often occur
in body folds and intertriginous areas, secondary to skin-to-skin
autoinoculation. Small, atypical, and giant lesions may be mistaken
for verrucae, keratosis pilaris, milia, bacterial pustules, or cutaneous
papules, such as juvenile xanthogranuloma.
Contents of the central core, obtained by needle extraction and
examined microscopically after staining with Wright or Giemsa stain,
display molluscum bodies, distinctive ovoid intracytoplasmic inclusions.