Pearled papules over tattoo: Molluscum cotagiosum
Ricardo Ruiz-Villaverde, Daniel Sánchez-Cano
The Pan African Medical Journal. ;16:49. doi:10.11604/pamj..16.49.3442

Create an account  |  Sign in
PAMJ - Clinical Medicine PAMJ - Clinical Medicine
"Better health through knowledge sharing and information dissemination "

Images in clinical medicine

Pearled papules over tattoo: Molluscum cotagiosum

Ricardo Ruiz-Villaverde, Daniel Sánchez-Cano
Pan Afr Med J. 2013; 16:49. doi:10.11604/pamj.2013.16.49.3442. Published 11 Oct 2013

A 23-year-old immunocompetent man attended to our dermatology unit complaining asympthomatic pearled papules over a previous black tattoo performed over his right abdominal flank. Past medical history was unremarkable. Physical examination showed several umbilicated skin-coloured papules on the tattooed skin and the surrounding skin. Serology results for syphilis, hepatitis B and C, and HIV were negative. Histology of one of the papules demonstrated multiple molluscum bodies. Curettage in programmed sessions was effective. No recurrences have been observed after 6 months. Molluscum contagiosum (MC) is a viral infection caused by a poxvirus. They are most commonly observed in children with atopic dermatitis although its incidence has increased in adults, predominantly due to HIV infection. Concretly when MC lesions affects perineal area, a sexually transmitted disease (STD) may be suspected. Common STD should be rule out. In our patient the appearance of molluscum lesions on the tattoo may be due to transmission of the virus through the instruments used in its implementation or prior contamination of the ink. Koebner phenomenon or "isomorphic response" is the main cause of the spread that many patients present at the time of consultation. Therapeutical approach includes three categories: a) Destructive: curettage, cryotherapy and topical application of keratolytic agents (potassium hydroxide 5–10% in aqueous solution); b) immunomodulatory: imiquimod 5% cream and c) antiviral: podofilotoxin solution, cidofovir. Otherwise in certain cases papules resolve spontaneously.

Corresponding author:
Ricardo Ruiz-Villaverde, Dermatology Unit. Complejo Hospitalario de Jaen, Jaen, Spain; Carretera Bailen-Motril s/n 23001 Jaen, Spain

©Ricardo Ruiz-Villaverde et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

More images in clinical medicine


PAMJ Images in Medicine and Public Health are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 34 (September - December 2019)

This image

Share this image:

Filter images [Reset filter]

By language

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2019 - Pan African Medical Journal. All rights reserved