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21-Year-Old Male with Asymptomatic Papular Eruption on Chest

Can you diagnose this case?

David L. Kaplan, MD

Signs and Symptoms

This 21-year-old man presented for evaluation with a 3-month history of an asymptomatic papular eruption on his chest. He was otherwise healthy.

What is the cause of this man’s rash?

Choose one to reveal diagnosis and discussion

Warts
Molluscum contagiosum
Staphylococcal folliculitis
Herpes simplex
Shaving folliculitis

Answer: Molluscum contagiosum

See the full case at Consultant360

These umbilicated papules were consistent with molluscum contagiosum. This poxvirus typically is seen in prepubescent children who have atopic dermatitis and in young adults as a sexually transmitted infection. This patient was believed to have acquired molluscum contagiosum in the gym while lifting weights, although it is possible he acquired the infection via skin-to-skin contact elsewhere. Destructive modalities such as cryotherapy are effective therapies.

Typically, warts are not as inflamed as these lesions or umbilicated. Staphylococcal and herpetic infections are typically symptomatic. There is no evidence of shaving as a cause in this patient’s case.

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