Idiopathic genital ulcer disease in an HIV-infected woman

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

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.