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PICTORIAL EDUCATION  
Year : 2022  |  Volume : 14  |  Issue : 1  |  Page : 41-42
Large crateriform molluscum on penis masquerading as keratoacanthoma


Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

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Date of Submission17-Jun-2021
Date of Acceptance30-Sep-2021
Date of Web Publication16-Feb-2022
 

How to cite this article:
Baisya S, Mallick S, Sarawgi D, Rudra O. Large crateriform molluscum on penis masquerading as keratoacanthoma. J Global Infect Dis 2022;14:41-2

How to cite this URL:
Baisya S, Mallick S, Sarawgi D, Rudra O. Large crateriform molluscum on penis masquerading as keratoacanthoma. J Global Infect Dis [serial online] 2022 [cited 2022 Jun 25];14:41-2. Available from: https://www.jgid.org/text.asp?2022/14/1/41/337728





   Short History Top


A 52-year-old man presented with painless, slowly enlarging lesions on his penis for the last 3 months. General examination was noncontributory. Cutaneous examination revealed reddish pink-colored nodules on the penis, which were roughly round to oval in shape with elevated border, measuring approximately 1.5–2 cm. The center of each nodule was ulcerated and covered with black eschar [Figure 1]a and [Figure 1]b. On palpation, these were soft in consistency, noncompressible, nontendered, and nonindurated. There was no history of surface discharge. No such lesions were present elsewhere on the body. The lesions were slowly enlarging initially; however, for the last 1 month, it enlarged rapidly. Regional lymph nodes were nonpalpable. Routine blood investigations along with western blot test were advised, and the patient was found to be HIV negative. Venereal Disease Research Laboratory test and Treponema Pallidum Hemagglutination assay were nonreactive. Gram stain revealed no cocco-bacilli, suggestive of Haemophilus ducreyi. No past history of high-risk exposure and tuberculosis was present. On the basis of case history and clinical findings, provisional diagnosis of keratoacanthoma was made. Histopathology revealed hypergranulosis and characteristic molluscum bodies [Figure 1]c. The final diagnosis was molluscum contagiosum (MC). The patient was treated with 10% potassium hydroxide solution.
Figure 1: (a and b) Multiple nodules with central ulceration; (c) histopathology showing molluscum bodies

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Differential diagnosis

  1. Keratoacanthoma
  2. Chancre
  3. Chancroid
  4. Tubercular ulcer
  5. Cryptococcosis.



   Discussion Top


MC was first described in the medical literature in 1817. Its viral etiology was determined by Juliusberg.[1] MC is a common skin and mucosal disease of viral origin, caused by molluscum contagiosum virus (MCV) virus of poxvirus family. With the eradication of smallpox, MCV is now the only member of the poxvirus family that causes substantial disease in humans. Poxviruses utilize the microtubule cytoskeleton within the cytoplasm of eukaryotic cells for moving into the human host cell during establishment of infection and for facilitating the continued spread of virus infection.[2] MC is mostly transmitted by direct skin-to-skin contact through wet skin. Histopathological examination reveals the lesions involving the follicular epithelium. The lesion is acanthotic and cup shaped. In the cytoplasm of prickle cells, numerous small eosinophilic and later basophilic inclusion bodies called molluscum bodies or Henderson–Paterson bodies are formed. Lesions that rupture into dermis may elicit a marked suppurative inflammatory reaction that resembles an abscess.[3] Although frequently reported, its unusual clinical presentation makes its diagnosis a challenging task.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Research quality and ethics statement

The authors followed applicable EQUATOR Network (“http:// www.equator-network.org/) guidelines, notably the CARE guideline, during the conduct of this report.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
ZurKenntnis JM. Des virus des Molluscum contagiosum. Dtsch Med Wochenschr. 1905;31:1598–99.  Back to cited text no. 1
    
2.
Ploubidou A, Moreau V, Ashman K, Reckmann I, González C, Way M. Vaccinia virus infection disrupts microtubule organization and centrosome function. EMBO J 2000;19:3932-44.  Back to cited text no. 2
    
3.
James WD, Berger TG, Elston DM. Viral diseases. Andrews' Diseases of the Skin. The Clinical Dermatology. 10th ed. Canada: Saunders Publication; 2006. p. 394-7.  Back to cited text no. 3
    

Top
Correspondence Address:
Dr. Subhadeep Mallick
244 AJC Bose Road, Kolkata - 700 020, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jgid.jgid_165_21

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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
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