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Prsentation Clinique

H de 46 ans. Lsions nodulaires du pubis et du pnis.    



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Deux lsions sont examines, l'une se prsentant sur coupe comme un nodule enchass dans le derme, et l'autre comportant un pertuis abouch l'piderme. Les deux structures sont formes par un revtement pidermique hyperplasique, avec maturation vers une couche granuleuse paisse, donnant une couche corne anormale, toutes deux constitues de cellules prsentant un effet cytopathique virale par surcharge d'inclusions virales cytoplasmiques, osinophiles.


Diagnostic Propos:



Molluscum contagiosum (Akerman's Surgical Pathology)

Molluscum contagiosum is a skin disease characterized by small, firm, usually multiple nodules that, when fully developed, have central cores from which white keratinous material can be expressed. The
microscopic picture is characteristic. The dermis is indented by a sharply delimited and lobulated
mass of proliferating epithelium. As the cells differentiate within the mass, their cytoplasm gradually is filled by a faintly granular eosinophilic inclusion that displaces the nucleus and enlarges the cells. These molluscum bodies are formed of viral particles that are similar in size and mode of formation to the poxviruses. Inflammation in the surrounding dermis is intense, sometimes to the point of simulating a leukemic process. Metaplastic ossification has been occasionally observed. 

Reed and Parkinson studied the histogenesis of molluscum contagiosum and concluded that the lesion ariseson the basis of follicular neogenesis. They found areas of hair bulb differentiation at the periphery, occasionally associated with areas of sebaceous gland differentiation. However, the disease can also appear in places where there are no hair follicles, such as the palms, indicating that the epidermis itself may be affected.