A healthy 40-yo woman on no meds originally from sub-Saharan Africa c/o 5 mo of itchy papules around her mouth. Exam showed a cluster of pearly papules. What is it?
Acne vulgaris
Molluscum contagiosum
Folliculitis
Herpes simplex
Milia
You are correct. Molluscum lesions are small, benign, pearly papules caused by a poxvirus. Molluscum is most common on the face and trunk in children and in the genital area in sexually active adults. Molluscum is uncommon on the face of healthy adults and should prompt investigation for immunocompromise, including CBC and HIV serology. This patient was found to be HIV positive and was treated with HAART and topical imiquimod. Molluscum infection is usually self-limited, and treatment is not required in otherwise healthy patients.
A young woman presented with lesions on her lips, tongue, and oral mucosa. Finger lesions and low-grade fever began a few days after the oral lesions. What is it?
Kawasaki disease
Impetigo
Behcet's disease
Herpes simplex
Coxsackie virus
You are correct. Swabs from the lesions tested positive for HSV1 by PCR. Occasionally, as in this case, autoinoculation can cause lesions at multiple sites. HSV1 is usually uncomplicated in immunocompetent hosts. Lesions last 10 to 14 days. Oral antiviral treatment shortens the duration and reduces symptoms.