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            Telah dilaporkan satu kasus jarang moluskum kontagiosum generalisata pada seorang anak laki-laki dengan imunokompromais serta usia 12 tahun, yang datang dengan keluhan utama timbul bintil hampir di seluruh tubuh sejak setahun yang lalu. Pasien juga menderita asma sejak usia 5 tahun dan mendapat pengobatan kortikosteroid yaitu deksametason 0,5-1 mg/hari selama 5 tahun, bila terjadi serangan. Pada pemeriksaan dijumlah papul multipel sewarna kulit, permukaan berkilat, ukuran lentikular, diskret, terdapat delle, perabaan keras dan tersebar generalisata. Pada pemeriksaan jumlah limfosit CD4 dan CD8 menurun secara bermakna. Pemeriksaan anti-human immunodeficiency virus (HIV) nonreaktif. Gambaran histopatologis terdapat badan moluskum. Terapi dengan tetes kantaridin, diaplikasikan tertahap. Selain itu diberikan imunostimulator, yaitu met-isoprinol untuk memperbaiki sistem imun.

            Patut dipikirkan modalitas pengobatan lain, msalnya interferon-a subkutan, sidovofir intravena, atau kombinasi tetes kantaridin dengan imikuimod topikal, mengingat lesi yang sangat ekstensif. Penulusuran lebih lanjut masih diperlukan untuk mencari penyebab pasti penurunan sistem imun selular pada pasien ini.

Kata kunci: moluskum kontagiosum generalisata, defek imun selular, kantaridin

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A very rare case of moluscum contagiosum generalisata in a twelve-year old boy is reported. Patient came to the hospital with papules all over his body since one year ago. The papules started on the back of his neck and spread all over his body and were very itchy. He also has been suffering from asthma bronchial and treated with dexamethasone 0.5-1 mg/day, for five years. On examination there were numerous shiny papules, lenticular in size, discrete some with delle. There was very significant decrease in CD4 and CD8 count. The HIV antibody was non-reactive. Pathologic examination revealed molluscum bodies. The lesions were treated with topical cantharidin, applied periodically.

This is a very rare case of generalized molluscum contagiosum. Extensive skin lesion usually occurs in an immunocompromised patient. In this case, cellular immunity defect might due to the prolonged use of corticosteroid. Immunostimulator drug (met-isoprinol) was also given besides topical cantharidin. Other modalities such as subcutaneous interferon-α, intravenous cidovofir and combination of cantharidin-topical imiquimod should be considered. Further investigation is needed to find other causes of cellular immunity defect.

Keywords: generalized  molluscum contagiosum, cellular immunity defect, cantharidin