Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 2609  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Articlesmenu-bullet Search Instructions Online Submission Subscribe Etcetera Contact
 :: Next article
 :: Previous article 
 :: Table of Contents
 ::  Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::Related articles
 ::  Article in PDF (296 KB)
 ::  Citation Manager
 ::  Access Statistics
 ::  Reader Comments
 ::  Email Alert *
 ::  Add to My List *
* Registration required (free) 

  IN THIS Article
 ::  Discussion
 ::  References
 ::  Article Figures

 Article Access Statistics
    PDF Downloaded186    
    Comments [Add]    
    Cited by others 5    

Recommend this journal


Year : 2001  |  Volume : 47  |  Issue : 4  |  Page : 268-9

Molluscum contagiosum and Job's syndrome.

Department of Paediatrics, Seth G. S. Medical College and K. E. M. Hospital, Parel, Mumbai - 400 012, India., India

Correspondence Address:
M N Martins
Department of Paediatrics, Seth G. S. Medical College and K. E. M. Hospital, Parel, Mumbai - 400 012, India.
Login to access the Email id

Source of Support: None, Conflict of Interest: None

PMID: 11832646

Rights and PermissionsRights and Permissions

Keywords: Case Report, Child, Preschool, Human, Job′s Syndrome, complications,pathology,therapy,Male, Molluscum Contagiosum, complications,pathology,therapy,

How to cite this article:
Martins M N, Tullu M S, Mahajan S A. Molluscum contagiosum and Job's syndrome. J Postgrad Med 2001;47:268

How to cite this URL:
Martins M N, Tullu M S, Mahajan S A. Molluscum contagiosum and Job's syndrome. J Postgrad Med [serial online] 2001 [cited 2022 Nov 28];47:268. Available from:

A three-and-half-year-old male child presented with fever, cough and breathlessness of four day’s duration. The child was diagnosed as a case of Job’s Syndrome (Hyper-IgE syndrome) at the age of two years (IgE level: 15062 IU/ml; reference range: 10-180 IU/ml) and had previous three admissions for lower respiratory tract infections. The child had respiratory distress and crepitations were heard bilaterally. He also had multiple papular lesions scattered on the face and the neck [Figure - 1]. These were diagnosed as molluscum contagiosum on a skin biopsy [Figure - 2]. The chest radiograph revealed bronchopneumonia with multiple pneumatocoeles in both the lungs. Investigations revealed anaemia (haemoglobin: 7.3 g/dl; PCV: 25%), leukocytosis (count of 25,900 cells/cumm), eosinophilia (absolute eosinophil count of 518 cells/cumm), high ESR (55 mm at 1 hr), hypoxia on arterial blood gas analysis and normal liver and renal function tests. Coagulase negative staphylococcus was isolated from the skin swab. The patient was treated with oxygen, intravenous fluids and intravenous vancomycin and amikacin (for 14 days). The extraction of some of the molluscum contagiosum lesions was performed. For the remaining lesions, the child is on treatment with topical Tretinoin cream (0.05% locally).

  ::   Discussion Top

Job’s syndrome is a rare primary immunodeficiency disorder characterised by extremely high levels of serum immunoglobulin E (IgE) and recurrent serious staphylococcal infections of skin, lungs, joints, etc.[1],[2] Variable associated features include coarse facies, cold cutaneous abscesses, eczematous rashes and osteopenia.[2] Apart from high serum IgE levels, blood and sputum eosinophilia and poor cell-mediated and antibody responses to neoantigens may be present.[1],[2] Also, variable defects of mononuclear and/or polymorphonuclear chemotaxis is present in some cases.[1],[2] Treatment necessitates the use of antibiotics for the infections and surgical drainage of the abscesses.[2] Long-term treatment with penicillinase-resistant penicillin is recommended to prevent recurrent infections.[1],[2] Intravenous immunoglobulin may be administered to those with antibody-deficiency. Surgery may be required for superinfected pneumatoceles or pneumatoceles persisting beyond six months.[1],[2]

Molluscum contagiosum lesions are characterized by single or multiple, rounded, dome shaped, pink waxy papules ranging from 1 to 5 mm (rarely up to 1 cm) in diameter.[3] The causative agent is a DNA poxvirus. The lesions are umbilicated and contain a caseous plug. These lesions are commonly seen on the face, eyelids, neck, axillae and thighs. The mode of acquisition is via direct contact with an infected person or via fomites and spread occurs by autoinoculation.[3] Histologically, there are cells with intracytoplasmic inclusion bodies, also called molluscum bodies or Henderson Paterson bodies [Figure - 2]. These first appear as single, minute, ovoid eosinophilic structures in the stratum malphigium and become increasingly prominent as the cells move upwards from the basal layer to the stratum corneum.[3] There may be spontaneous resolution of the lesions over few months. In cases with widespread lesions and in those with immunosuppression, thorough treatment is necessary.[4] Treatment of the patient also prevents spread to other family members. The management entails extraction of the lesions with a curette. Other modalities of management include - use of local Tretinoin, liquid nitrogen, cantharidin (0.9%), benzoyl peroxide, trichloroacetic acid, cryotherapy, etc.[3],[4] A lesion-free period of 4 months can be considered as cure.[3] Molluscum contagiosum is an epidermal disorder and over-treatment should be avoided to prevent scarring.[3]

This case is being presented to highlight the occurrence of multiple lesions of molluscum contagiosum in a child with Job’s syndrome. Extensive lesions of molluscum contagiosum can occur in immunodeficient children and in those with atopic dermatitis.[3] It is unclear whether patients with Job’s syndrome are at an increased risk for developing extensive or severe viral infections. Viral infections like molluscum contagiosum need intact cell- mediated immunity for combating the infection. Job’s syndrome is known to be associated with poor antibody and cell- mediated responses to neo-antigens. This may be a possible reason for extensive molluscum contagiosum lesions in our case.

 :: References Top

1. Buckley RH. Combined B- and T-cell diseases. In: Nelson WE, Behrman RE, Kliegman RM, Arvin AM (editors). Nelson Textbook of Pediatrics. 15th ed. Philadelphia: W.B. Saunders Company (Bangalore: Prism Books Pvt Ltd); 1996. pp 573-577.  Back to cited text no. 1    
2.Salaria M, Poddar B, Parmar V. Hyperimmunoglobulin E syndrome. Indian J Pediatr 2001; 68: 87-90.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Darmstadt GL, Lane A. Cutaneous viral infections. In: Nelson WE, Behrman RE, Kliegman RM, Arvin AM (editors). Nelson Textbook of Pediatrics. 15th ed. Philadelphia: W.B. Saunders Company (Bangalore: Prism Books Pvt Ltd); 1996. pp 1901-1903.  Back to cited text no. 3    
4.Lowy DR. Milkers Nodules; Molluscum Contagiosum. In: Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM, Austen KF (editors). Dermatology in General Medicine. 2nd ed. New York: McGraw Hill Book Company; 1979. pp 1626-1628.   Back to cited text no. 4    


[Figure - 1], [Figure - 2]

This article has been cited by
1 Interferon-alpha treatment of molluscum contagiosum in a patient with hyperimmunoglobulin E syndrome
Kilic SS, Kilicbay F
PEDIATRICS. 2006; 117 (6): E1253-E1255
2 Unusual coexistence of molluscum contagiosum and verruca plana in a hyper-IgE syndrome
Lei XB, Geng SM, Zeng WH, et al.
3 Importance of life-long continuous antimicrobial prophylaxis to prevent infections in patients with Jobs syndrome
Agarwal R, Tullu MS, Lahiri KR
ARCHIVES OF MEDICAL RESEARCH. 2004; 35 (4): 359-360
4 Autosomal recessive hyperimmunoglobulin E syndrome: A distinct disease entity
Renner ED, Puck JM, Holland SM, et al.
JOURNAL OF PEDIATRICS. 2004; 144 (1): 93-99
5 Molluscum contagiosum with unusual localization: A case report
Camplone, G., La Pietra, M., Laino, L., Innocenzi, D.
Dermatologia Clinica. 2003; 23(2): 75-76


Print this article  Email this article
Previous article Next article
Online since 12th February '04
© 2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow