Molluscum contagiosum (MC) lesions on the face are mainly observed in HIV patients and are related to low CD4 cells counts. We report a 41-year-old female patient infected with human immunodeficiency virus who had a CD4 count of 22 cells/mm³. She developed molluscum contagiosum lesions at the right upper eyelid. Skin biopsy was performed to exclude other serious conditions, such as dimorphic fungal infections. A good response was observed with three sessions of curettage and topical application of 70 percent trichloroacetic acid. Facial molluscum contagiosum lesions can be a cutaneous marker of severe immunosuppression in HIV patients and skin biopsy is important in ruling out the diagnosis of dimorphic fungal infections.