Answers
Samar Razaq in Difficult Cases in Primary Care, 2021
Molluscum contagiosum is a poxvirus infection caused by direct skin contact. Sharing towels, baths or swimming pools with affected children may result in spread of the virus. Sexual transmission is the more likely route in the adolescent population. The lesions may become itchy because of surrounding eczema. Scratching can result in autoinoculation, as the mollusca spread along the skin in the direction of the scratching finger, occasionally producing linear lesions. Parents should be reassured that treatment is not required and the lesions will eventually settle on their own, usually without scarring. However, parents occasionally insist on treatment, particularly if the lesions increase in number. A large-bore needle may be used to puncture the lesion. Alternatively, if the child is able to tolerate it, cryotherapy may be attempted.
Cutaneous Manifestations of Sexually Transmitted Disease in the HIV-Positive Patient
Clay J. Cockerell, Antoanella Calame in Cutaneous Manifestations of HIV Disease, 2012
The diagnosis of molluscum contagiosum (MC) is usually made on the basis of clinical examination alone, but in certain patients the diagnosis can be challenging. Use of a magnifying lens may aid visualization of central umbilication in smaller lesions. If the diagnosis remains in doubt, a smear of a scraping of a lesion examined microscopically followed application of potassium hydroxide (KOH) or by Wright or Giemsa staining (known as Tzanck preparation) is a useful bedside procedure. The molluscum bodies can be visualized by light microscopy as football-shaped oval structures with the KOH preparation or as fuschia-colored structures on Tzanck preparation. Analysis of lesions by biopsy where pathognomic molluscum bodies are readily seen can yield a definitive diagnosis. In most cases, there are tightly circumscribed groups of infected keratinocytes with numerous discrete ovoid intracytoplasmic inclusion bodies. On hematoxylin and eosin staining, the inclusion bodies are eosinophilic but basophilic at the surface. A polyclonal antibody has been developed that recognizes MCV in fixed tissue via immunohistochemical techniques,249 and in situ hybridization for MCV DNA has also been used,250although these are rarely necessary.
Infantile Atopic Dermatitis
Donald Rudikoff, Steven R. Cohen, Noah Scheinfeld in Atopic Dermatitis and Eczematous Disorders, 2014
Appropriate management of the id reaction should primarily be focused on educating patients and their families, reassuring them, and encouraging conservative management with topical emollients and antibiotics should the lesions become infected. However, in symptomatic patients, other treatment should be discussed. Short periods of topical steroids may be used for severely pruritic id reactions. However, long-term use of topical steroids or immunomodulating therapies should be discouraged, because it may delay the ultimate resolution of molluscum contagiosum. In addition, the treatment of molluscum contagiosum lesions in rare cases for symptomatic patients may involve local destruction or surgery. However, in cases where patients present with an id reaction to molluscum contagiosum and are otherwise asymptomatic, clinicians should adopt watchful waiting and avoid destructive treatments, because these eruptions signify the development of an immune response to the virus and likely impending viral clearance.
Treatment of molluscum contagiosum with an East Indian sandalwood oil product
Published in Journal of Dermatological Treatment, 2018
Molluscum contagiosum is a common skin condition seen primarily in children. The lesions appear as umbilicated papules and may occur anywhere on the body. The lesions are typically asymptomatic but may be pruritic and, depending on location, may be unattractive and embarrassing. It is caused by a DNA poxvirus and is spread by contact with the affected area or with fomites used by the infected person (1). The natural course of the disorder is for spontaneous resolution to occur, typically over a 6- to 18-month period (2). While the rash generally resolves without treatment, this prolonged period and other factors will often lead patients to seek more expedient treatment. Unfortunately, molluscum rash is hard to eradicate, and available treatments are generally not satisfactory and are typically painful. One study found the most effective in-office treatment to be curettage (3) which has potential to leave scars as well as being painful. Cryosurgery is another uncomfortable alternative. Cantharidin is the most common in-office treatment, but it and other preparations using salicylic acid or potassium hydroxide commonly have stinging, burning and pain associated with their use (3). In addition, cantharidin is typically not used on the face or near the eyes. Over the counter treatments intended for use at home include topical retinoids and imiquimod but their efficacy is also limited. A Cochrane review found there is no evidence to show that any particular treatment is effective for the treatment of molluscum infection (4). An effective, painless topical treatment suitable for use on the body or face for molluscum infections would meet the needs of many people who suffer with these conditions.
Common dermatological conditions in the HIV patient
Published in South African Family Practice, 2019
It is caused by a poxvirus and is common in HIV patients. Typical lesions are skin-coloured, dome-shaped papules or nodules, often with a central umbilication. Lesions may be quite extensive in immunocompromised patients (Figure 3). In HIV, lesions may be atypical and resemble other conditions such as bacillary angiomatosis.1 Treatment of molluscum contagiosum in HIV patients includes restoration of immune competence by highly active antiretroviral therapy (HAART). In some patients lesions respond to immunomodulators like imiquimod 5%.
A comparative study of topical cantharidin and intralesional PPD to treat molluscum contagiosum
Published in Journal of Dermatological Treatment, 2020
Fathia M. Khattab, Mohamed M. Nasr
Molluscum contagiosum is a skin or sometimes mucous membrane viral infection. It is triggered by a molluscum contagiosum virus (MCV) called a DNA poxvirus (1). There is no reservoir of animals in the virus (infecting only humans). There are four types of MCV, MCV-1 to -4; the most common is MCV-1, and MCV-2 is generally seen in adults (2).
Related Knowledge Centers
- Immunosuppression
- Molluscum Contagiosum Virus
- Poxviridae
- Abdomen
- Skin
- Lesion
- Viral Disease
- Sex Organ
- Scar
- Sexual Activity