Molluscum contagiosum diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Overview

There are no criteria for the diagnosis of molluscum contagiosum. Although the diagnosis is primarily based on characteristic appearance of the lesions, diagnostic studies that can be used include histologic examination, dermoscopic examination and electron microscopy of biopsies.

Diagnostic criteria

  • Dermoscopic examination can also be useful for supporting a clinical diagnosis and confirmation of molluscum contagiosum. In dermoscopic exam, a central umbilication with polylobular, white to yellow amorphous structures will be visualized which is typical for the disease. This exam allows physicians to evaluate primary morphology of skin lesions.[1] [2]
  • In dermoscopic exam a peripheral crown of radiating or punctiform vessels may also be seen. Dermoscopy exams of molluscum contagiosum lesions provide a higher specificity for the disease than other diagnostic methods. The presence of vessels, orifices, and specific vascular patterns helps in determining the diagnosis and in differentiating molluscum contagiosum from other diseases. [3]
  • Electron microscopy of biopsies is not usually indicated due to the cost and feasibility, but if done, will demonstrate typical brick-shaped poxvirus particles. Electron microscopy can also identify infected cells that may be missed with light microscopy due to normal appearance. [4]

References

  1. Haliasos EC, Kerner M, Jaimes-Lopez N, Rudnicka L, Zalaudek I, Malvehy J, Hofmann-Wellenhof R, Braun RP, Marghoob AA (2013). "Dermoscopy for the pediatric dermatologist part I: dermoscopy of pediatric infectious and inflammatory skin lesions and hair disorders". Pediatr Dermatol. 30 (2): 163–71. doi:10.1111/pde.12097. PMID 23405886.
  2. Morales A, Puig S, Malvehy J, Zaballos P (2005). "Dermoscopy of molluscum contagiosum". Arch Dermatol. 141 (12): 1644. doi:10.1001/archderm.141.12.1644. PMID 16365277.
  3. Ianhez M, Cestari Sda C, Enokihara MY, Seize MB (2011). "Dermoscopic patterns of molluscum contagiosum: a study of 211 lesions confirmed by histopathology". An Bras Dermatol. 86 (1): 74–9. PMID 21437525.
  4. Smith KJ, Skelton HG, Yeager J, James WD, Wagner KF (1992). "Molluscum contagiosum. Ultrastructural evidence for its presence in skin adjacent to clinical lesions in patients infected with human immunodeficiency virus type 1. Military Medical Consortium for Applied Retroviral Research". Arch Dermatol. 128 (2): 223–7. PMID 1739301.