Spontaneous Regression of Generalized Molluscum Contagiosum Turning Black

Case Details

Personal Characteristics

A 15-month-old male infant

Clinical Characteristics

Numerous eruptive papules, approximately 650 tiny pearly papules with a central delle, papular lesions, inflammatory with an erythematous halo, turned black in the central delle, flattened or was destroyed spontaneously, healed with a slightly elevated scar

Remission Characteristics

During a few weeks, each of the inflamed papules with blackening flattened or was destroyed spontaneously, eventually undergoing involution. Four months after the patients initial visit, almost all of the papules regressed and healed with a slightly elevated scar

Treatment & Mechanisms

Proposed Remission Mechanisms

The mechanism involved in the phenomenon of spontaneous resolution of the inflammatory mc with blackening is discussed

Clinical Treatment

5% sulfadiazine pasta

Additional Notes

Histological examination of a biopsy specimen from an inflammatory large papule with a central black crust on the back revealed molluscum lobules surrounded by dense infiltrates of a mixture of lymphocytes, histiocytes and polymorphonuclear leukocytes and diffuse epidermal necrosis. The cellular infiltrates were extending into a damaged overlying epidermis showing degeneration and necrosis. The stratum corneum and degenerated Malpigian layer had focal areas of clotted blood and hemorrhage. Laboratory studies disclosed that the level of serum immunoglobulin IgA decreased to 19 mg/dl (normal: 26 to 74 mg/dl) while serum IgG, M, and E were within normal limits. Indirect immunofluorescent study showed that a circulating IgG antibody against molluscum bodies was positive at a titer of 1:32 (dilution).