Clinico-Dermoscopic Report of Molluscum Dermatitis: A Pearly Puzzle in Focus

We report an 18-year-old male who presented with a two-month history of a lesion over his right forearm with a one-week history of sudden increase in size associated with pain. General and systemic examinations were normal. Dermatological examination revealed a single tender, well-defined, pearly white to erythematous, dome-shaped nodule of approximately 6mm x 5mm x 5mm with central umbilication and surrounding erythema. Dermoscopy revealed a central poly lobular white-yellow amorphous structure with a peripheral punctiform vascular pattern, collarette of scaling, and circumferential homogenous red area. Intracytoplasmic eosinophilic and basophilic inclusion bodies were found on the Tzanck smear. With the above clinical and dermoscopic findings, a diagnosis of molluscum contagiosum (MC) with molluscum dermatitis was made. Following curettage and removal of the contents of the lesion, the surrounding inflammation resolved completely within 20 days. This report emphasizes the fact that curettage of the primary MC lesion itself leads to the resolution of molluscum dermatitis, negating the need for additional topical steroid therapy. The unreported dermoscopic features of molluscum dermatitis in this report provide valuable insights into distinguishing molluscum dermatitis from other dermatological conditions with similar presentations.