Molluscum contagiosum-induced comedo and secondary abscess formation

A 9-year-old boy had recurrent formation of fluctuating abscesses of the forearms, leading to surgical incisions. Histopathologic examinations revealed that the etiologic agent was a molluscum virus in the lower portion of a pilosebaceous follicle, which formed a comedo. The comedones developed into pustular and cystic lesions after the boy attempted to squeeze out the contents. Two different reaction patterns to molluscum contagiosum seem to be present: a lymphocyte-mediated immunologic reaction in normally regressing lesions, and an acute inflammatory reaction due to disruption of infected epidermal tissue into the dermis, as seen in this patient.