HAART – The best treatment modality for widespread and disfigured giant molluscum contagiosum

Abstract

Molluscum contagiosum (MC) is a common viral infection caused by molluscum contagiosum virus (MCV), a double-stranded DNA virus which belongs to Poxviridae family. It is frequently seen in young children and sexually active adults. The transmission of spread occurs both by sexual and nonsexual routes like direct contact with infected skin, mucous membrane or via fomites. The incubation period varies from two to six months. In immunocompetent persons, the molluscum lesions typically appear as painless, flesh-colored or skin-coloured, dome shaped papules of size 2-3mm with central umbilication that can appear anywhere on the body, but most often located on the face, neck and intertriginous sites like axilla and popliteal fossa. However, atypical forms (giant, verrucous, agminate forms) with involvement of genitalia are more common in immune – compromised persons particularly in sexually active adults. It is usually self-limited in immunocompetent individuals while in HIV-infected patients with advance disease, the lesions are more widespread and extensive. Due to its longer period of persistence and poor response to conventional therapies, the clinicians often face difficulties to treat it. Several reports document that variety of treatment options had been tried for widespread molluscum contagiosum but none had been considered to be the ideal and standard treatment. Herein, we report a case of 6-year-old HIV-infected boy with multiple, tumour like nodules (agminate variety); a rare presentation of molluscum contagiosum over face and other body parts which successfully resolved with exclusive HAART therapy.