Two for One: Concurrent Acquisition of Molluscum Contagiosum Infection and Scabies Infestation After a Single Sexual Encounter

Abstract

Molluscum contagiosum and scabies are contagious conditions that can be acquired by incidental casual contact of a disease-free individual with an infected person. However, both the viral infection and the mite infestation can be transmitted sexually from the infected person to the unsuspecting recipient partner. A 20year-old man without any infectious diseases acquired not only molluscum contagiosum but also scabies after a single sexual encounter with a female partner; hence, he developed two sexually transmitted diseases after one sexual episode: two for one. He presented for medical attention to evaluate the new white umbilicated papules on his penile shaft and red nodules on the corona and glans of his penis. A complete skin examination also revealed additional papules on his abdomen and suprapubic region and a burrow on his left index finger adjacent to the finger web. Diagnosis of the molluscum contagiosum infection was confirmed by observing molluscum bodies on the molluscum preparation taken from an abdominal papule and the scabies infestation was confirmed by noting not only mite eggs but also mite scybala (feces) on the scabies (mineral oil) preparation from the burrow. The molluscum contagiosum infection was treated with curettage of the lesions. The scabies infestation was treated with two treatments (each one week apart) of permethrin five percent cream overnight topical application from his neck to his toes. All his lesions resolved and did not recur. In conclusion, the development of a new sexually transmitted disease in an individual should prompt the clinician to evaluate the patient for additional sexually transmitted diseases since the patient may have acquired more than one infection from their partner during the sexual encounter.

Drug eruption-like scabies surrepticius: an uncommonly described variant of scabies appearing in a non-classic clinical presentation

“…Classic scabies presents with lesions, referred to as burrows, that are often found on flexure sites such as the web spaces between fingers and the wrists [3,4]. In addition, the lesions not only have a predilection to appear on the areola and umbilicus, but also can be found on areas covered by the patient's underwear such as the belt line, buttocks, genitalia, and groin [3,7]. Hyperkeratotic subungual lesions may be an unsuspected reservoir for persistent infestation in scabies patients with therapy-resistant or recurrent mite infestation [3,[8][9][10].…”

“…Indeed, the nomenclature scabies surrepticius was coined in 2017 to provide a term for the medical lexicon that encompassed all the non-classic clinical presentations associated with this mite [12]. Several subtypes of scabies surrepticius have been described (Table 1), [1,3,5,[7][8][9][10]; the patient of Adris et al exemplifies the uncommonly described drugeruption-like scabies surrepticius subtype [1].…”