Atypical Presentation of Molluscum Contagiosum on the Thorax: Diagnostic and Therapeutic Approach

Abstract

Molluscum contagiosum is a common viral skin infection in the pediatric population caused by a virus belonging to the Poxviridae family, characterized by the appearance of progressively growing umbilicated pearly papules. Although it commonly affects the face, extremities, and trunk, extensive or atypical forms may represent a diagnostic and therapeutic challenge. We present the case of an 8-year-old immunocompetent male patient with multiple lesions predominantly located on the thoracic region with four months of evolution, associated with pruritus and progressive dissemination. Physical examination revealed multiple pearly hemispheric papules with central umbilication and grouped distribution on the anterior and right lateral thorax. Due to the unusual clinical presentation, dermoscopy and skin biopsy were performed, confirming the diagnosis of molluscum contagiosum through histopathological findings compatible with intracytoplasmic Henderson-Patterson bodies. Treatment consisted of selective curettage of the main lesions and complementary topical therapy associated with hygienic and dermatological measures to reduce autoinoculation. The patient showed satisfactory clinical evolution, adequate healing, and progressive resolution of the lesions without major complications. This case highlights the importance of considering molluscum contagiosum among the differential diagnoses of thoracic papular lesions in pediatric patients, as well as the usefulness of clinical and histopathological approaches for establishing timely and individualized treatment.