An 18-month-old child presents with several small, dome-shaped, pearly papules with central umbilication along the right upper eyelid margin, together with a unilateral follicular conjunctivitis of the same eye. The most likely causative agent is:

• A Herpes simplex virus type 1
• B Molluscum contagiosum virus, a poxvirus ✓
• C Human papillomavirus type 6
• D Varicella zoster virus

Explanation

Molluscum contagiosum, caused by a poxvirus, produces umbilicated pearly nodules; when situated on the lid margin, shed viral particles constantly bathe the conjunctiva and produce a chronic follicular conjunctivitis. Multiple or giant lesions raise the possibility of immunosuppression such as HIV. Herpes simplex causes vesicles that progress to dendritic corneal ulcers, HPV causes filiform warts without umbilication, and zoster follows a dermatomal distribution with a vesicular rash.

Reference: Parsons' Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.