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Molluscum contagiosum is a very common, benign, often self-limiting skin disease caused by Molluscum contagiosum virus, member of the poxvirus family. Genital ulcers in HIV positive women are usually acute or subacute, mostly idiopathic or aphtous. Sixty percent of cases are caused by herpes simplex virus syphilis or chancroid. We present a 31-yearold woman with a 2.5 month history of vulval ulceration and a several month history of molluscum contagiosum in the pubic region, neck and face. After she was admitted to our department, the patient underwent physical examination using enzyme-linked immunosorbent assay, and an immunoblot test for HIV 1/2. Both tests were positive. Thereafter, the patient was referred to an infectologist who recommended application of 5% imiquimod cream 3 times per week for molluscum contagiosum and acyclovir 3x400 mg/day. Considering that there are more accepted indications for HIV testing, we agree with other authors that all adults with molluscum contagiosum or chronic genital ulceration should be tested for HIV serology. Sažetak wUvod: Molluscum contagiosum je veoma često, benigno, često samolimitirajuće oboljenje kože koje je izazvano virusom Molluscum contagiosum, članom poxvirus porodice. Genitalni ulkusi kod HIV (eng. human immunodeficiency virus) pozitivnih žena najčešće su akutni ili subakutni, uglavnom idiopatski ili uzrokovani aftama (60%). Česti uzroci su i herpes simpleks virus (HSV), sifilis i šankroid. Prikaz slučaja: Prikazujemo pacijentkinju staru 31.godinu koja 2,5 meseca pre prijema u našu Kliniku primećuje ulceraciju na vulvi, a nekoliko meseci pre toga prisustvo molluscum contagiosum na koži pubisa, vrata i lica. Neposredno posle fizikalnog pregleda urađeni su ELISA i imunoblot testovi na HIV 1/2 i oba testa su bila pozitivna. Posle dobijanja nalaza, pacijentkinja je upućena infektologu s preporukom da nanosi 5% imikvimod krem 3x nedeljno na molluscumcontagiosum promene i da uzima aciklovir tablete 3x400mg dnevno. Zaključak: imajući u vidu da se indikacije za testiranje na HIV šire, slažemo se sa drugim autorima da jeneophodno testirati na HIV sve odrasle pacijente sa molluscum contagiosum ili hroničnom genitalnom ulceracijom.

serbian journal of dermatology and venereology/serbian journal of dermatology and venerology

Molluscum Contagiosum and Chronic Vulval Ulceration as the First Manifestations of HIV Infection – A Case Report / Molluscum contagiosum i hronične vulvalne ulceracije kao prve manifestacije HIV infekcije – prikaz slučaja