Multiple mollusca contagiosa on the eyelids following immunosuppression with methotrexate

Background Poxvirus induced molluscum contagiosum is known to occur in children, elderly people and in patients with the acquired immune deficiency syndrome AIDS. Patient and methods We report on a 49-year-old patient who presented with a three-month history of multiple skin-coloured prominent warts on his right upper and lower eyelid. On examination, the warts showed a central cavity and measured 2-6 mm in diameter. For his "mixed connective tissue disease" (MCTD) the patient took methotrexate in a weekly dosage of 7.5 mg since 3 years. Diagnosis of MCTD was made 7 pears before. The warts were excised and studied histopathologically. One year postoperatively, there was no recurrence of the lesions. Conclusion Drug induced immunosuppression as with methotrexate may be associated with multiple periocular lesions due to molluscum contagiosum.