Extensive exuberant giant molluscum contagiosum with ulceration in a female with acquired immunodeficiency syndrome with a CD4 count of 54 cells/mm ³ – an interesting case report with a brief review of the literature

A 49-year-old female, who denied high-risk behavior or history of blood transfusion or I/V drug abuse, presented with multiple confluent and discrete papules, nodules, plaques, and ulcers on the medial aspect of both thighs, posterior thigh, and buttocks. Some of the papules had central umbilication. There was no history of tuberculosis or any systemic serious disorders. Multiple treatments from various physicians did not have any benefit. Investigations revealed the patient as Human immunodeficiecy virus -1 positive with CD4 count of 54 cells/cu.mm. Impression smear and skin biopsy demonstrated intracytoplasmic eosinophilic inclusion bodies in the epidermis, suggestive of molluscum contagiosum (MC). Systemically, the patient had cytomegalovirus retinitis. We are reporting an atypical and rare presentation of MC. The patient was treated with antibiotics, cotrimoxazole, isssssssssntravenous ganciclovir, and is being worked up to start antiretroviral therapy.