1. Molluscum contagiosum surrounded by a white halo and Sezary syndrome
- Author
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J.-L. Schmutz, A. Barbaud, Florence Granel-Brocard, C. Le Treut, Anne-Claire Bursztejn, and F. Plenat
- Subjects
Cellular immunity ,medicine.medical_specialty ,Pathology ,Molluscum Contagiosum ,Eczema ,Dermatology ,Diagnosis, Differential ,Prednisone ,medicine ,Humans ,Sezary Syndrome ,Exanthem ,Aged ,Skin ,Molluscum contagiosum ,Chlorambucil ,business.industry ,medicine.disease ,Rash ,Infectious Diseases ,Female ,Differential diagnosis ,Clobetasol propionate ,medicine.symptom ,business ,medicine.drug - Abstract
Background Molluscum contagiosum (MC) is caused by a DNA virus of the poxvirus group. It is common in children, and is also found in sexually active adults and HIV-seropositive patients. Cellular immunity is essential to controlling MC virus infection. We report the first observation of a patient with stage IV Sezary syndrome, who presented multiple molluscum contagiosum, spread and surrounded by a pale halo. Case report A woman aged 70 presented with aggravation of Sezary syndrome diagnosed in 2009 and treated with topical corticosteroids. The examination showed a generalized pruritic exanthem and multiple flesh-coloured papules from 1 to 3 mm, spread over the entire skin surface and surrounded by a white halo. Histological examination of a lesion showed the presence of infected cells with intracytoplasmic inclusions infected in an acanthotic epidermis, surrounded by a melaninopenic hypomelanosis with a normal melanocyte density. There was no inflammatory character. The diagnosis of multiple molluscum contagiosum was given, the application of clobetasol propionate was suspended and treatment with chlorambucil 4 mg/day and prednisone 0.5 mg/kg/day was started. The evolution of the rash and pruritus was rapidly favourable. After 3 months, the rash and pruritus had regressed. There was no molluscum contagiosum or clear halo. Conclusion We report the original observation of a patient with stage IV Sezary syndrome, who presented multiple molluscum contagiosum, spread and surrounded by a pale halo, without inflammation, eczema or disappearance of melanocytes. This halo could be due to the secretion of a protein by molluscum contagiosum inhibiting inflammation around this MC. To our knowledge, this phenomenon reported in a patient with severe atopic dermatitis associated with Sezary syndrome has not previously been described.
- Published
- 2014
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