Introduction: Periocular molluscum contagiosum nodules typically appear in a classical presentation. However, the presentation can be different. This makes the diagnosis and the decision on treatment difficult.
Aim: To report different clinical presentations of periocular molluscum contagiosum and to examine their epidemiological, clinical and histopathological features.
Methods: For all patients who were diagnosed with periocular molluscum contagiosum during the years 1995-2014, the following data was extracted from the patients' files: gender, age at the time of diagnosis, location of the lesion, number and dimensions of lesions, clinical presentation, histopathological features, suspected clinical diagnosis before histopathological diagnosis and treatment. A classification according to different presentations was suggested and the epidemiological, clinical and histopathological features of each presentation were examined.
Results: Molluscum contagiosum was diagnosed in 30 patients: 10 males (33.33%) and 20 females (66.66%). The mean age of diagnosis was 19.3 years old, one patient was immunosuppressive and 29 patients were immunocompetent. Six different clinical presentations were seen: Typical, umbilicated dome shaped lesion (19 cases), big lesion (4 cases), conglomerated lesions (4 cases), erythematous lesion (1 case), inflamed lesion (1 case), and pedunculated lesion (1 case). In all cases the diagnosis was confirmed by histopathological examination and the treatment was surgical excision.
Conclusion: According to this case series of periocular molluscum contagiosum, which is one of the largest published thus far in the ophthalmic literature, six distinct different clinical presentations are suggested. These lesions should be suspected not just in children and in immunosuppressive adult patients but also in immunocompetent patients of all ages.