Molluscum contagiosum diagnostic criteria

There are no criteria for the diagnosis of molluscum contagiosum. Although the diagnosis is primarily based on characteristic appearance of the lesions, diagnostic studies that can be used include histologic examination, dermoscopic examination and electron microscopy of biopsies.

• Histologic examination can confirm the clinical diagnosis. Hematoxylin and eosin (H&E) staining of a molluscum contagiosum lesion will reveal cells and keratinocytes containing eosinophilic cytoplasmic inclusion bodies that are also known as molluscum bodies or Henderson-Paterson bodies.

• Dermoscopic examination can also be useful for supporting a clinical diagnosis and confirmation of molluscum contagiosum. In dermoscopic exam, a central umbilication with polylobular, white to yellow amorphous structures will be visualized which is typical for the disease. This exam allows physicians to evaluate primary morphology of skin lesions.^{[1] [2]}

• In dermoscopic exam a peripheral crown of radiating or punctiform vessels may also be seen. Dermoscopy exams of molluscum contagiosum lesions provide a higher specificity for the disease than other diagnostic methods. The presence of vessels, orifices, and specific vascular patterns helps in determining the diagnosis and in differentiating molluscum contagiosum from other diseases. ^[3]

• Electron microscopy of biopsies is not usually indicated due to the cost and feasibility, but if done, will demonstrate typical brick-shaped poxvirus particles. Electron microscopy can also identify infected cells that may be missed with light microscopy due to normal appearance. ^[4]