molluscum contagiosum is a double - stranded dna virus , which is the cause of benign , infectious disease of the skin that is characterized by dome - shaped papules with a central dell or depression clinically . in patients with altered or impaired immunity such as atopic dermatitis , after long term corticosteroid and immunosuppressive therapy use , sarcoidosis , leukemias , wiskott - aldrich syndrome and especially with acquired immune deficiency syndrome , atypical lesions of molluscum contagiosum may occur , often reaching a large size on an unusual site that can also mimic a wide spectrum of other conditions . the presence of giant molluscum contagiosum in immunocompetent patients is rare , and in some reviews it was reported to be a clue for hiv infection in both the pediatric patient group and adult patients . this rare infection must be kept in mind in patients who have solitary pink nodular lesions for a short time , especially on face and anogenital region . a 27-year - old male was admitted to our outpatient clinic with a 4-month history of a 1.5 cm in diameter , asymptomatic , pink nodular lesion on left temporal region ( figure 1 ) . dermoscopic examination revealed white - yellow structureless area in the center of the of lesion and increased linear vascularity on the periphery ( figure 2 ) . histopathologically epidermal hyperkeratosis , acanthosis , widespread viral cytopathic effect and intracytoplasmic inclusion bodies were seen ( figure 3 ) . his laboratory tests for immunsuppresssion , including complete blood counting , immunoglobulins and hiv serology were totally normal . molluscum contagiosum ( mc ) is a common infectious disease of the skin characterized by pearly dome - shaped papules with a central dell or depression located on the face , arms , legs and anogenital region , caused by the molluscum contagiosum virus . the virus replicates in the epidermis and enters the skin from a small skin defect leading to impaired skin barrier function or from contaminated items , such as towels or clothes . specific lesions of mc are usually smaller than 5 mm and less than 20 in number [ 14 ] . although it is known to be a disease of childhood , rarely it can be seen in adults . due to the characteristic appearance of the lesions , specific treatments or therapies are usually not administered for molluscum contagiosum infection in immunocompetent individuals , as lesions will resolve within time . dermoscopy of mc reveals a central pore or umbilication in association with polylobular white to yellowish amorphous structures , which are surrounded by linear , fine , corona - like telangiectasias   this apperance may change in atypical cases , especially in atypical localizations . giant mc is a rare nodular variant of molluscum contagiosum , which is 0.51 cm or more in diameter . this clinical presentation may mimic basal cell carcinoma , furuncle , intradermal nevus , amelanotic melanoma , kerathoacanthoma and viral warts . these lesions are rare in healthy children or adults and may accompany altered immunity , such as atopic dermatitis , corticosteroid and immunosuppressive therapy , sarcoidosis , leukemias , wiskott - aldrich syndrome and acquired immune deficiency syndrome . atypical lesions of molluscum contagiosum may occur often and reach large size with extensive distribution on unusual body parts . in our patient there are only a few case reports of giant molluscum contagiosum occurring in immunocompetent patients in the literature . there are also only a few case reports of molluscum contagiosum on the scalp in immunocompetent patients  one newborn and one elderly patient . cryotherapy , 10% koh application , trichloroacetic acid , imiqumod , systemic cimetidin , intralesional 5-fu and bleomycin and total excision are the main treatment options . we present this case to present giant molluscum in differential diagnosis of soft , slowly growing tumoral lesions with atypical presentation .
molluscum contagiosum is a benign cutaneous viral infection which is caused by double- stranded dna poxvirus . 
 it affects mainly children and young adults and usually presents with single or multiple umblicated papules or nodules on face , arms , legs and anogenital regions . 
 it may present in atypical size and clinical appearance in patients with altered or impaired immunity and rarely in immuncompetent patients . 
 herein we present an immuncompetent young adult patient with isolated giant molluscum contagiosum , which was mimicking epidermoid cyst clinically .