Widespread Molluscum Contagiosum with Atopic Dermatitis-like Skin Manifestations.

A 55-year-old man presented with generalized eczema and nodules. Physical examination revealed eczematous skin lesions on the face, trunk and extremities, with localized lichenification (Fig. 1A). Poikilodermatous skin changes were observed in the anterior neck and upper chest (Fig. 1B). In addition, numerous whitish dermal nodules 0.5–2 cm in diameter were observed on the trunk and extremities (Fig. 1C, D). Eczema had been noticed since infancy, while dermal nodules appeared at approximately 20 years of age. The patient’s height was 155 cm and his hair was slightly sparse (Fig. 1E), but bamboo-like hair features were not evident. He had protruding ears, scoliosis, hallux valgus, congenital absence of 7 permanent teeth, but no nail changes. His past history included congenital hip dislocation, bronchial asthma during infancy, duodenal ulcer, psychological depression, bilateral ocular retinal detachment and cataract, and recurrent herpetic keratoconjunctivitis. He had no history of recurrent bacterial infections on the skin or in the respiratory tract. Computed tomography revealed no abnormal findings, including thymoma. Histological examination of the eczematous lesions revealed acanthosis with weak spongiosis and dermal lymphocytic infiltration. The whitish nodules were histopathologically diagnosed as molluscum contagiosum (Fig. 1F). We were unable to obtain detailed clinical information for other family members. The results of laboratory tests are shown below and in Table I. The patient showed markedly increased levels of serum IgE (82,362 IU/ml) with specific IgE against house dust (49.3 UA/ml, class 4), Dermatophagoides farinae (50.2 UA/ml, class 5), Japanese cedar (42.7 UA/ml, class 4), Japanese cypress (3.23 UA/ml, class 2), Japanese alder (1.67 UA/ml, class 2), ragweed (3.54 UA/ml, class 3), crab (5.61 UA/ml, class 3), shrimp (3.35 UA/ml, class 2), tuna (1.09 UA/ml, class 2), Candida (57.2 UA/ml, class 5) and Staphylococcus aureus enterotoxin A (5.16 UA/ml, class 3). Serum levels of thymus and activationregulated chemokine (TARC) (34,050 pg/ml) were also elevated. Widespread Molluscum Contagiosum with Atopic Dermatitis-like Skin Manifestations