Molluscum contagiosum in two HIV-positive patients. Unusual findings with immunological and therapeutical evaluation

Molluscum contagiosum is a benign, often self-limiting skin disorder resulting from infection by a Pox-virus. The immunodeficiency conditions whether primary or secondary, may be associated with several viral skin infections with clinical features not usually observed. We report the clinical, therapeutical and immunological findings in two adult patients affected with molluscum contagiosum infection and the acquired immunodeficiency syndrome (AIDS). In particular the two patients showed hundreds of lesions disseminated on the face, neck and scalp; the face involvement is typical of childhood while in adults the infection is sexually transmitted and the lesions are observed in the genital area. Both cryotherapy by itself and in association with interferon α2b injections failed to produce any improvements: the lesions continued to increase in number and size. Monthly immunological assessments of the patients for a period of 1 year support earlier evidence that the molluscum contagiosum virus may act as an opportunistic pathogen. Moreover, this association between disseminated molluscum infection and HIV infection constitutes a difficult problem to handle therapeutically. This difficulty in management seems to be correlated to the absolute depletion of T helper lymphocytes typical of the late stages of AIDS.