Which skin lesion has a dome shaped waxy umbilicated appearance and is caused by a DNA pox virus?

The skin lesion characterized by a dome-shaped, waxy appearance with an umbilicated center and caused by a DNA poxvirus is indeed molluscum contagiosum. This condition typically presents as small, painless papules that can vary in color from flesh-toned to white, often with a central dimple, which is a hallmark sign of this viral infection. Molluscum contagiosum is particularly known for its contagious nature and can be transmitted through direct skin contact, commonly in children and in adults through sexual contact as well.

The other options, while they involve skin lesions, do not fit the specific description provided in the question. Basal cell carcinoma is typically characterized by pearly nodules with telangiectasia and does not exhibit the umbilicated appearance. Squamous cell carcinoma presents as scaly, crusted lesions or ulcers that can be aggressive, lacking the dome-shaped or waxy characteristics. Actinic keratosis usually appears as rough, scaly patches due to sun damage, again diverging from the filamentous and smooth texture of molluscum contagiosum lesions. Therefore, the unique aspects of molluscum contagiosum make it the correct choice in this context.