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Original article
IMAGES IN PAEDIATRICS
Molluscum contagiosum infection on a congenital intermediate melanocytic naevus A 2-year-old girl presented with a 3-month history of several small painless papules, growing on the surface of an abdominal congenital melanocytic naevus (MN). Her mother noted that the lesions were significantly increasing in number and size. There was no history of trauma and her medical and family histories were unremarkable. Physical examination revealed multiple skin-coloured, translucent, glossy, dome-shaped papules, ranging from 1 to 3 mm, localised exclusively on the surface of a macular, smooth, light to dark brown, non-hypertrichotic congenital intermediate MN (2×4 cm) (see figure 1). The dermoscopic examination of the papules suggested the diagnosis of molluscum contagiosum (MC), which was histologically confirmed. MC is a common viral skin infection, which is seldom associated with other skin diseases (eg, epidermoid cyst and nevocellular naevus).1 The localisation of MC on an MN is extremely rare, and only a few case reports have been published in the literature until now; in all reported cases, the lesions are strictly confined to the MN and did not affect the remaining skin.2 3 A possible explanation of the occurrence of viral lesions on an MN may be represented by the Meyerson’s phenomenon, an eczematous reaction occurring in MN.4 We could hypothesise that this resulted in a barrier dysfunction predisposing the patient to develop MC locally. Even though congenital intermediate MN is recognised to have a low malignancy potential during childhood,5 melanoma can develop. Therefore, the physician should be aware of the appearance of MC superinfection on MN, but the occurrence of new lesions within a congenital MN requires a dermatological evaluation. 1
1
1
2
Iria Neri, Michela Magnano, Riccardo Balestri, Katharina Kleinschmidt, Annalisa Patrizi1
Figure 1 Multiple discrete skin-coloured, dome-shaped papules on a congenital intermediate melanocytic naevus. Correspondence to Dr Michela Magnano, Division of Dermatology, Department of Specialised, Experimental and Diagnostic Medicine, University of Bologna, S. OrsolaMalpighi Hospital, via Massarenti 1, Bologna 40138, Italy; michela.magnano@ gmail.com Competing interests None. Patient consent Obtained. Provenance and peer review Not commissioned; externally peer reviewed.
To cite Neri I, Magnano M, Balestri R, et al. Arch Dis Child 2014;99:1008. Accepted 11 August 2014 Published Online First 2 September 2014 Arch Dis Child 2014;99:1008. doi:10.1136/archdischild-2014-306930
REFERENCES 1 2 3 4
1
Division of Dermatology, Department of Specialised, Experimental and Diagnostic Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy Pediatric Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
2
1008
5
Cribier B, Scrivener Y, Grosshans E. Molluscum contagiosum: histologic patterns and associated lesions. A study of 578 cases. Am J Dermatopathol 2001;23:99–103. Dobrosavljevic D, Brasanac D, Lukic S, et al. Molluscum contagiosum arising in melanocytic nevus and in superficial spreading melanoma. J Cutan Pathol 2009;36:461–3. Garcia-Romero MT, Pope E. Rapidly growing papular lesions on a giant congenital melanocytic nevus. Int J Dermatol 2013;52:1109–10. Pižem J, Stojanovič L, Luzar B. Melanocytic lesions with eczematous reaction (Meyerson’s phenomenon)—a histopathologic analysis of 64 cases. J Cutan Pathol 2012;39:901–10. Tannous ZS, Mihm MC Jr, Sober AJ, et al. Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol 2005;52:197–203.
Singh P, et al. Arch Dis Child 2014;99:1004–1008. doi:10.1136/archdischild-2013-305567
Downloaded from http://adc.bmj.com/ on June 6, 2015 - Published by group.bmj.com
Molluscum contagiosum infection on a congenital intermediate melanocytic naevus Iria Neri, Michela Magnano, Riccardo Balestri, Katharina Kleinschmidt and Annalisa Patrizi Arch Dis Child 2014 99: 1008 originally published online September 2, 2014
doi: 10.1136/archdischild-2014-306930 Updated information and services can be found at: http://adc.bmj.com/content/99/11/1008
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This article cites 5 articles, 0 of which you can access for free at: http://adc.bmj.com/content/99/11/1008#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Dermatology (332) Oncology (710) Competing interests (ethics) (155) Clinical diagnostic tests (1041) Journalology (207) Child health (3634)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Original article
IMAGES IN PAEDIATRICS
Molluscum contagiosum infection on a congenital intermediate melanocytic naevus A 2-year-old girl presented with a 3-month history of several small painless papules, growing on the surface of an abdominal congenital melanocytic naevus (MN). Her mother noted that the lesions were significantly increasing in number and size. There was no history of trauma and her medical and family histories were unremarkable. Physical examination revealed multiple skin-coloured, translucent, glossy, dome-shaped papules, ranging from 1 to 3 mm, localised exclusively on the surface of a macular, smooth, light to dark brown, non-hypertrichotic congenital intermediate MN (2×4 cm) (see figure 1). The dermoscopic examination of the papules suggested the diagnosis of molluscum contagiosum (MC), which was histologically confirmed. MC is a common viral skin infection, which is seldom associated with other skin diseases (eg, epidermoid cyst and nevocellular naevus).1 The localisation of MC on an MN is extremely rare, and only a few case reports have been published in the literature until now; in all reported cases, the lesions are strictly confined to the MN and did not affect the remaining skin.2 3 A possible explanation of the occurrence of viral lesions on an MN may be represented by the Meyerson’s phenomenon, an eczematous reaction occurring in MN.4 We could hypothesise that this resulted in a barrier dysfunction predisposing the patient to develop MC locally. Even though congenital intermediate MN is recognised to have a low malignancy potential during childhood,5 melanoma can develop. Therefore, the physician should be aware of the appearance of MC superinfection on MN, but the occurrence of new lesions within a congenital MN requires a dermatological evaluation. 1
1
1
2
Iria Neri, Michela Magnano, Riccardo Balestri, Katharina Kleinschmidt, Annalisa Patrizi1
Figure 1 Multiple discrete skin-coloured, dome-shaped papules on a congenital intermediate melanocytic naevus. Correspondence to Dr Michela Magnano, Division of Dermatology, Department of Specialised, Experimental and Diagnostic Medicine, University of Bologna, S. OrsolaMalpighi Hospital, via Massarenti 1, Bologna 40138, Italy; michela.magnano@ gmail.com Competing interests None. Patient consent Obtained. Provenance and peer review Not commissioned; externally peer reviewed.
To cite Neri I, Magnano M, Balestri R, et al. Arch Dis Child 2014;99:1008. Accepted 11 August 2014 Published Online First 2 September 2014 Arch Dis Child 2014;99:1008. doi:10.1136/archdischild-2014-306930
REFERENCES 1 2 3 4
1
Division of Dermatology, Department of Specialised, Experimental and Diagnostic Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy Pediatric Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
2
1008
5
Cribier B, Scrivener Y, Grosshans E. Molluscum contagiosum: histologic patterns and associated lesions. A study of 578 cases. Am J Dermatopathol 2001;23:99–103. Dobrosavljevic D, Brasanac D, Lukic S, et al. Molluscum contagiosum arising in melanocytic nevus and in superficial spreading melanoma. J Cutan Pathol 2009;36:461–3. Garcia-Romero MT, Pope E. Rapidly growing papular lesions on a giant congenital melanocytic nevus. Int J Dermatol 2013;52:1109–10. Pižem J, Stojanovič L, Luzar B. Melanocytic lesions with eczematous reaction (Meyerson’s phenomenon)—a histopathologic analysis of 64 cases. J Cutan Pathol 2012;39:901–10. Tannous ZS, Mihm MC Jr, Sober AJ, et al. Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol 2005;52:197–203.
Singh P, et al. Arch Dis Child 2014;99:1004–1008. doi:10.1136/archdischild-2013-305567
Downloaded from http://adc.bmj.com/ on June 6, 2015 - Published by group.bmj.com
Molluscum contagiosum infection on a congenital intermediate melanocytic naevus Iria Neri, Michela Magnano, Riccardo Balestri, Katharina Kleinschmidt and Annalisa Patrizi Arch Dis Child 2014 99: 1008 originally published online September 2, 2014
doi: 10.1136/archdischild-2014-306930 Updated information and services can be found at: http://adc.bmj.com/content/99/11/1008
These include:
References Email alerting service
Topic Collections
This article cites 5 articles, 0 of which you can access for free at: http://adc.bmj.com/content/99/11/1008#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Dermatology (332) Oncology (710) Competing interests (ethics) (155) Clinical diagnostic tests (1041) Journalology (207) Child health (3634)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
