Case Of Molluscum Contagiosum Research Articles

Analysis of pediatric outpatient visits uncovers disparities in molluscum contagiosum treatment across medical specialties in the United States.

Molluscum contagiosum (MC) is a common viral infection that affects the skin of children. In this study, treatment regimens and demographic information for MC patients across US medical specialties were compared. We discovered an average of 471,383 pediatric MC visits annually using the National Ambulatory Medical Care Survey database from 2000 to 2016. Non-Hispanics (82.9%) and Caucasians (91.0%) made up the majority of the visitors. The majority of cases were handled by pediatricians (46.5%), family medicine doctors (10.6%), and dermatologists (36.7%). Compared to pediatricians, dermatologists saw a higher percentage of Caucasian patients (95% vs.84%) and patients with private insurance (83% vs. 73%). Patients were more likely to see family medicine doctors (55.0%) in non-metropolitan areas than pediatricians (26.4%) or dermatologists (16.3%). Dermatologists were less likely than pediatricians (38%) to favor spontaneous resolution (70%). Dermatologists favored terpenoids (20%), imiquimod (12%), and curettage (10%), while pediatricians primarily used terpenoids (12%), steroids (4%), and imiquimod (4%). The majority of MC cases are managed by pediatricians; however, treatment approaches deviate markedly from recommended best practices.

Molluscum Contagiosum Virus Evasion of Immune Surveillance: A Review.

Molluscum contagiosum (MC) is an acute infection caused by the molluscum contagiosum virus (MCV) with a worldwide incidence of approximately 8,000 cases per 100,000 individuals annually. Greater than 90% of MC cases occur in the pediatric population, and affected adults are more likely to be younger or immunocompromised. MC has minimal inflammation initially; however, a strong inflammatory response can occur during resolution of the infection, termed the beginning of the end (BOTE). MC infections may last months to years, and it is hypothesized that persistent infections may be due to suppression of immunity by MCV proteins, thus affecting MC’s clinical progression. We reviewed the current proposed mechanisms of MCV immune evasion and discuss potential therapeutic options for MC treatment. A literature search was conducted using electronic databases (Pubmed, Google Scholar, Medline). We compiled 18 original research articles and identified 11 proteins produced by MCV that are postulated to participate in evasion of host immunity through various molecular pathways. These proteins and/or their downstream pathways may be influenced by MC treatments in phase 3 development, including berdazimer gel 10.3% and VP-102 cantharidin, 0.7%. MCV is distinctive in evading immune surveillance by inhibiting or dampening several immune pathways via the production of viral proteins. The result is decreasing local inflammatory response which contributes to the prolonged survival of MCV in the epidermis. Persistent MC can be a nuisance for some patients and treatment may be desired. Currently, no treatment has been approved by the US Food and Drug Administration (FDA). Two approaches in the pipeline may affect the immune avoidance mechanisms; nevertheless, their exact mechanisms between the potential therapeutics and viral proteins remain enigmatic. J Drugs Dermatol. 2023;22(2):182-189. doi:10.36849/JDD.7230.

Homoeopathic treatment of molluscum contagiosum: A case report

Introduction: The prevalence of molluscum contagiosum is estimated to be around 8000 cases per 100,000 annually. Molluscum contagiosum is a common disease that tends to affect children and immunocompromised adults. Most cases of molluscum contagiosum will clear up naturally within two years (usually within nine months). So long as the skin growths are present, there is a possibility of transmitting the infection to another person. When the growths are gone, the possibility of spreading the infection is ended, so a treatment approach which could cure the disease in a shorter period of time compared to its mean duration of course is always warranted.Case report: We present a case of 7 years old female child suffering from multiple dome – shaped, dimpled centre, pearly eruptions on face for 15 days. The patient was diagnosed by carefully observing the appearance of her lesions, which were flesh-coloured, dome-shaped, and pearly in appearance, 1–5 mm in diameter, with a dimple in centre. So, depending on the totality of symptoms of the patient, she was prescribed with Bacillinum 200/3 doses and asked to report after 1 month. The patient attended the OPD after 1 month and there was complete disappearance of the eruptions on her face.Conclusion: Homoeopathy is a system of medicine where we treat the patient as a whole and not the disease and this case is a simple demonstration of the fact that homoeopathy can be very effective in the treatment of viral infections such as Molluscum Contagiosum in a shorter period of time compared to the conventional modern mode of treatment.

Molluscum contagiosum of the corneal limbus in an AIDS patient: a clinicopathological case report

BackgroundMolluscum contagiosum, a pox virus infection, is likely to occur in the eyelid skin; however, corneal involvements by molluscum lesions are extremely rare. We report a case of molluscum contagiosum arising in the corneal limbus in an untreated AIDS patient, together with anterior segment optical coherence tomography (OCT) findings and histopathology of the excised tumor.Case presentationA 46-year-old man with AIDS was referred to our department for the management of an ocular lesion. Blood tests revealed an extremely low CD4+ T-cell count of 11 cells/μL, being strongly positive for anti-HIV antibody (591.36 S/CO) with a high copy number of HIV RNA (8070.0 × 100 copy/mL). Slit-lamp examination of his right eye showed a white nodule at the lower limbus. Anterior segment OCT findings of the nodule revealed a highly reflective elevated lesion, which was considered to involve the Bowman layer. The nodular lesion was excised from the limbus including the superficial corneal stroma, and then processed for histologic examination. Histopathology of the excised lesion showed acanthotic corneal epithelium containing swollen cells with eosinophilic inclusions known as molluscum bodies. He was diagnosed with molluscum contagiosum.ConclusionsAnterior segment OCT findings provide useful information for morphological evaluations of and preoperative strategies against molluscum contagiosum.

Molluscum contagiosum treated with individualized homoeopathic medicine: A case report

Molluscum contagiosum is infectious, benign skin condition. Typically present with umbilicated papule. A 15-year-old male patient presented popular eruption on neck with itching. After clinical examination and characteristic umbilicated papule, it was diagnosed as case of molluscum contagiosum. On the basis of presentation and characteristic symptoms, the patient was treated with individualized homoeopathic medicine. After a span of 4 months the papules were found to be disappeared. Rationale of this particular case is to show the better outcome of molluscum contagiosum with individualized homoeopathic medicines.

82例传染性软疣皮肤镜特征分析

82例传染性软疣皮肤镜特征分析

Dermoscopic rosettes as a clue for atypical molluscum contagiosum

Molluscum contagiosum (MC), a frequent viral infection, is generally easy to diagnose because of its characteristic clinical features. However, atypical presentations can be a diagnostic challenge for clinicians. Dermoscopy has helped in this cases by showing a characteristic dermoscopic pattern composed of a central pore or umbilication in conjunction with polylobular white to yellow amorphous structures, surrounded by linear or branched vessels (‘red crown”). However, additional dermoscopic patterns can be found. Herein we present two MC cases where rosettes were seen on dermoscopy

Periocular molluscum contagiosum: six different clinical presentations.

To describe the different clinical presentations of periocular molluscum contagiosum (MC) lesions and their epidemiological, clinical and histopathological features. Medical records and histopathological sections of all cases of periocular MC treated at the oculoplastic clinic of the Goldschleger Eye Institute, Sheba Medical Center, Israel, between 1995 and 2016 were retrospectively reviewed. The following data were extracted: gender, age at the time of MC diagnosis, immune competency, location of the periocular lesions, number of lesions, dimensions of the lesions, clinical presentation, histopathological features, suspected clinical diagnosis before histopathological diagnosis and treatment. The series was composed of 41 patients (19 males, 22 females) whose mean age at presentation was 20.41 ± 21.10years (range 1-71years). Only one patient was immunosuppressed. The cases were classified into six proposed clinical presentations: 'umbilicated nodular', 'big/giant', 'conglomerated', 'erythematous', 'inflamed' and 'pedunculated'. This is the first time that different clinical types of MC lesions are labelled. The current evidence also indicates that MC lesions should be suspected not only in children and in immunosuppressed adult patients but also in immunocompetent patients of all ages.

Plasmacytoid dendritic cells in skin lesions of classic Kaposi's sarcoma.

Plasmacytoid dendritic cells (pDCs) are the most potent producers of type I interferons (IFNs), which allows them to provide anti-viral resistance and to link the innate and adaptive immunity by controlling the function of myeloid DCs, lymphocytes, and natural killer cells. pDCs are involved in the pathogenesis of several infectious [especially viral, such as Molluscum contagiosum (MC)], inflammatory/autoimmune, and neoplastic entities. Kaposi's sarcoma (KS) is a multifocal, systemic lympho-angioproliferative tumor associated with Kaposi's sarcoma-associated herpesvirus (KSHV) infection. Microscopy typically exhibits a chronic inflammatory lymphoplasmacytic infiltrate in addition to the vascular changes and spindle cell proliferation. Despite the extensive research done on the immune evasion strategies employed by KSHV, pDCs role in relation to KS has only rarely been investigated. Given this, we intend to investigate pDC occurrence and activity in the skin lesions of KS. Immunohistochemical staining for BDCA-2 (specific pDC marker) and MxA (surrogate marker for local type I IFN production) was performed on classic KS (n=20) with the control group comprising inflamed MC (n=20). As expected, BDCA-2+ pDCs were present in abundance with diffuse and intense MxA expression (indicative of local type I IFN production) in all inflamed MC cases (20 of 20, 100%). Though present in all the KS cases, pDCs were significantly less abundant in KS than in inflamed MC cases, and MxA expression was patchy/weak in most KS cases. In summary, pDCs are part of the inflammatory host response in KS; however, they were generally low in number with decreased type I IFN production which is probably related to KSHV's ability to evade the immune system through the production of different viral proteins capable of suppressing IFN production as well as pDC function.

A Case of Molluscum Contagiosum in an Adult Patient with Rheumatoid Arthritis, Following Combination Therapy with Adalimumab, Methotrexate and Prednisolone

A Case of Molluscum Contagiosum in an Adult Patient with Rheumatoid Arthritis, Following Combination Therapy with Adalimumab, Methotrexate and Prednisolone

Molluscum contagiosum and associations with atopic eczema in children: a retrospective longitudinal study in primary care.

Molluscum contagiosum (MC) is a common skin condition in children. Consultation rates and current management in primary care, and how these have changed over time, are poorly described. An association between the presence of atopic eczema (AE) and MC has been shown, but the subsequent risk of developing MC in children with a diagnosis of AE is not known. To describe the consultation rate and management of MC in general practice in the UK over time, and test the hypothesis that a history of AE increases the risk of developing MC in childhood. Two studies are reported: a retrospective longitudinal study of MC cases and an age-sex matched case-cohort study of AE cases, both datasets being held in the UK Clinical Practice Research Datalink from 2004 to 2013. Data of all recorded MC and AE primary care consultations for children aged 0 to 14 years were collected and two main analyses were conducted using these data: a retrospective longitudinal analysis and an age-sex matched case-cohort analysis. The rate of MC consultations in primary care for children aged 0 to 14 years is 9.5 per 1000 (95% CI = 9.4 to 9.6). The greatest rate of consultations for both sexes is in children aged 1-4 years and 5-9 years (13.1 to 13.0 (males) and 13.0 to 13.9 (females) per 1000 respectively). Consultation rates for MC have declined by 50% from 2004 to 2013. Children were found to be more likely to have an MC consultation if they had previously consulted a GP with AE (OR 1.13; 95% CI = 1.11 to 1.16; P<0.005). Consultations for MC in primary care are common, especially in 1-9-year-olds, but they declined significantly during the decade under study. A primary care diagnosis of AE is associated with an increased risk of a subsequent primary care diagnosis of MC.

Primitive follicular induction in molluscum contagiosum.

Molluscum contagiosum (MC) is the commonest human poxvirus infection. Follicular induction has rarely been observed in the epidermis surrounding lesions of MC. A virus-induced localized proliferation of germinative/stem cells of the folliculosebaceous-apocrine unit has been suggested as the underlying cause, however few reports of this peculiar phenomenon exist in the literature and the mechanisms involved in this proliferation require further study. We prospectively collected MC cases showing multifocal areas of primitive follicular induction involving the adjacent undersurface epidermis. Immunohistochemical expression of BerEP4, PHLDA1 and cytokeratin 20 (CK20) was evaluated in the basaloid germs surrounding the lesions. For PHLDA1, we used epidermal melanocytes as a positive internal control. For BerEP4, we employed a basal cell carcinoma (BCC) and for CK20, colon as positive external controls. An incubation without the primary antibody functioned as an external negative control. All the cases studied showed an intense positive staining of the basaloid buds with BerEP4 and weaker stain for PHLDA1. CK20 showed the presence of scattered Merkel cells within the induced epidermal basaloid proliferations favoring their reactive origin. The pathogenetic mechanisms behind the development of these microscopic features and the link between follicular induction and poxvirus infection are explored. Awareness of this unusual phenomenon by dermatopathologists will be helpful in avoiding a misdiagnosis of a superficial BCC in such cases. BerEP4 and PHLDA1 were consistently expressed in the areas of primitive follicular induction surrounding lesions of MC. CK 20 stained the Merkel cells present in the basaloid buds. All these findings support the reactive origin of this phenomenon, which we believe is most probably viral-induced.

Topical fig sap induced phytophotodermatitis to eradicate molluscum contagiosum and flat warts

Folk medicine describes the use of figs to treat skin lesions. This therapeutic use of fig sap is even mentioned in the Bible. Fig sap can cause irritant or phototoxic reactions when combined with sun exposure termed Phytophotodermatitis. Contact with plant-derived phototoxic substances (furocoumarins or psoralens) followed by sunlight exposure produces clinical lesions that have therapeutic activity for small skin lesions. In children, conventional topical treatment of flat warts or Molluscum Contagiosum may be difficult because of poor compliance. Here, we present two cases of induced phytophotodermatitis by using fig sap over a period of 4-6 weeks to treat multiple flat warts in a 12-year-old boy, and a case of Molluscum Contagiosum in a 6-year-old girl. These cases suggest an alternative treatment for skin lesions.

Molluscum contagiosum in a pediatric American Indian population: incidence and risk factors.

BackgroundMolluscum contagiosum virus (MCV) causes an innocuous yet persistent skin infection in immunocompetent individuals and is spread by contact with lesions. Studies point to atopic dermatitis (AD) as a risk factor for MCV infection; however, there are no longitudinal studies that have evaluated this hypothesis.MethodsOutpatient visit data from fiscal years 2001–2009 for American Indian and Alaska Native (AI/AN) children were examined to describe the incidence of molluscum contagiosum (MC). We conducted a case-control study of patients <5 years old at an Indian Health Service (IHS) clinic to evaluate dermatological risk factors for infection.ResultsThe incidence rate for MC in children <5 years old was highest in the West and East regions. MC cases were more likely to have a prior or co-occurring diagnosis of eczema, eczema or dermatitis, impetigo, and scabies (p<0.05) compared to controls; 51.4% of MC cases had a prior or co-occurring diagnosis of eczema or dermatitis.ConclusionsThe present study is the first demonstration of an association between AD and MC using a case-control study design. It is unknown if the concurrent high incidence of eczema and MC is related, and this association deserves further investigation.

Successful treatment of molluscum contagiosum with intralesional immunotherapy by measles, mumps, and rubella vaccine: a report of two cases

Molluscum contagiosum (MC) is a common viral infection of the skin and mucous membrane that often affects young children. Generally, physical removal by surgical curettage is commonly used for the treatment of MC, but the pain during the treatment is a major problem. Thus immunotherapy using various antigens has been introduced recently. Here we present two cases of MC that improved with measles, mumps, and rubella (MMR) vaccine intralesional injection. On the ground of our knowledge, they were the first cases of successful MMR intralesional injection in this disease entity.

Molluscum contagiosum involving an epidermoid cyst – a rare association and potential source of clinical misdiagnosis

Molluscum contagiosum (MC) is a viral infection of skin and mucous membrane commonly affecting the adolescents and young adults. Extensive lesions are usually common in immunocompromised patients. We herein report a rare case of molluscum contagiosum in an epidermoid cyst (EC) in a 24-year-old immunocompetent male. The provisional clinical diagnosis was inflammed epidermoid cyst or lipoma. On histopathological examination, the lesion displayed a unilocular epidermoid cyst in deep dermis, the lining of which was infected by molluscum contagiosum virus with characteristic inclusions. The overlying epidermis was absolutely normal having no attachment with the cyst.

Follicular Induction in a Case of Molluscum Contagiosum

Molluscum contagiosum (MC) can rarely show follicular neogenesis as a result of proliferation of virus-infected basal cells. We report a case of molluscum contagiosum showing multifocal areas of primitive follicular induction involving the adjacent surface epidermis. The underlying dermis showed histological features suggestive of secondary anetoderma. The pathogenetic mechanisms behind development of these microscopic features and the putative link between follicular induction and secondary anetoderma are explored. Awareness of this unusual phenomenon will be helpful in avoiding a misdiagnosis of a superficial basal cell (trichoblastic) carcinoma in such cases.

Molluscum contagiosum: Study of four cases

Molluscum contagiosum (MC) is an infection of skin caused by Poxvirus and usually affects any part of the body as pearly pink umbilicated lesion. Immunocompromised patients are more easily prone for this viral infection. Here, we present four cases of MC affecting various locations in the body.

Neonatal Molluscum contagiosum: five new cases and a literature review

Congenital or neonatal Molluscum contagiosum (MC) is an unusual infection, barely reported in the literature. In these patients a mechanism of transmission that is neither via contact or sexual transmission should be considered. We describe five cases of neonatal MC and review the cases already published to discuss the possible aetiopathogenic mechanism.

Rare Manifestation of Giant Molluscum Contagiosum on the Scalp in Old Age

Dear Editor: A 64-year-old man presented to our department of hospital with a one-month history of skin lesion on the scalp. Physical examination revealed a skin-colored nodule on the left temporal scalp (Fig. 1A) and a skin-colored verrucous surfaced plaque on the right temporal area (Fig. 1B). The lesions gradually increased in size. The patient had no previous history of skin disease or recurrent infection. Further history-taking and clinical examination did not reveal any risk factors or evidence of an immunocompromised state. Fig. 1 Skin-colored hard papules of the (A) left, and (B) right temporal scalp. The left one measured 10×10 mm; the right, 12×12 mm. Histopathological examination of a punch biopsy specimen from the center of the lesions showed the classic pattern of molluscum contagiosum: subcorneal cysts and intracytoplasmic inclusion bodies, the so-called molluscum bodies, connected with the epidermal surface (Fig. 2). Based on the clinical features and histopathological findings, we diagnosed molluscum contagiosum. After diagnosis, the molluscum were removed by curettage, and no recurrence had been observed at one-year follow-up. Fig. 2 Small subcorneal cyst-like structure containing white keratinous material and intracytoplasmic inclusion bodies (H&E, ×200). Molluscum contagiosum is a benign, infectious disease of the skin that presents as pearly dome-shaped papules with a central dell or depression. Although worldwide in its distribution, molluscum contagiosum has been most frequently encountered as an easily treated disease of childhood and has rarely been a cause of serious morbidity1. It occurs most commonly in children and adolescents, and is usually localized on the face, arms, legs and anogenital regions. Due to the characteristic appearance of the lesions, diagnosis is generally made without laboratory testing. Often specific treatments or therapies are not pursued for molluscum contagiosum infection in immune competent individuals, as lesions will resolve with time. In an immunocompetent state, a lesion may usually last two to four months, and the development of new lesions by autoinoculation is common. Most cases resolve spontaneously in six to nine months. In conditions that involve 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 reaching a large size on an unusual site2. In a thorough review of the medical literature, we were able to find 13 case reports of giant molluscum contagiosum occurring in immunocompetent patients2-4. Most of these patients were children without immunodeficiency. There has been only one case of molluscum contagiosum on the scalp in an immunocompetent patient, who was a newborn5. In this case, the skin lesions showed no spontaneous resolution and autoinoculation during eight months. Our patient was 64 years old. With advanced age, human T cells reveal reductions in the proliferative response to activation, in diversity of the T-cell receptor antigen repertoire, and in cytolytic activity. B cells of aging individuals show reduced response to certain viral infections or vaccinations. Thus, the atypical clinical manifestation of our patient might be attributable to a possible decline in immune function due to advanced age. In the case reported here, the patient had no history of atopic dermatitis or other immune disorders. The predilection of the scalp area and the old age of our patient are interesting. To our knowledge, this is first case of giant molluscum contagiosum on the scalp in an older immunocompetent patient.