Mollusca Contagiosa Research Articles

Paediatric onset lymphomatoid papulosis: results of a multicentre retrospective cohort study, on behalf of the EORTC Cutaneous Lymphoma Tumours Group (CLTG).

Lymphomatoid Papulosis (LyP) is a rare cutaneous T-cell lymphoproliferative disorder. Comprehensive data on LyP in the paediatric population is scarce. To characterize epidemiological, clinical, histopathological, and prognostic features of paediatric LyP. This was a retrospective, multicentre international cohort study including 87 cases of children and adolescents with LyP diagnosed between 1998 and 2022. Patients aged ≤ 18 years old at disease onset were included. Diagnosis was made in each centre based on clinical-pathological correlation. Eighty-seven patients from 12 centres were included. The mean age at onset was 7.0 years (range 3 months-18 years) with a male to female ratio of 2:1. The mean time between onset of first cutaneous lesions and diagnosis was 1.3 years (range 0-14 years). Initial misdiagnosis concerned 26.4% of patients. Initially, LyP was most often misdiagnosed as Pityriasis lichenoides et varioliformis acuta (PLEVA), insect bites, or mollusca contagiosa. Erythematous papules or papulonodules were the most frequent clinical presentation. Pruritus was specifically mentioned for 20.7% of patients. The main histological subtype was type A in 55.1% of the cases. If analysed, monoclonal TCR rearrangement was found in 76.5% of the skin biopsies. The overall survival rate was 100% with follow up at 5 years available for 33 patients and at 15 years for 8 patients. A development of associated haematological malignancy (HM) occurred in 9.6% of the cases (7/73), including four mycosis fungoides (MF) cases, one primary cutaneous anaplastic large cell lymphoma (pc-ALCL), one systemic ALCL and one case of acute myeloid leukaemia. If we compare incidence rates of cancer with the world 0-19 years old population from 2001-2010, we estimate a significantly higher risk of associated malignancy in general, occurring before the age of 19 years old with incidence rate ratio of 87.49 (CI 86.01-88.99). We report epidemiological data from a large international cohort of children and adolescents with LyP. Overall the prognosis of the disease is good, with excellent survival rates for all patients. Due to increased risk of associated HM, a long-term follow-up should be recommended for LyP patients.

Potassium hydroxide 5 % solution in actinic keratosis : Anovel therapeutic approach in the lesion-directed treatment

HintergrundDie aktinische Keratose (AK) ist ein epitheliales Carcinoma in situ der Haut. Aufgrund des Risikos einer malignen Transformation besteht ein frühzeitiger Behandlungsbedarf. Gerade die initiale Therapie sollte neben der Wirksamkeit eine gute Verträglichkeit und Anwenderfreundlichkeit aufweisen. Kaliumhydroxid (KOH)-Lösung ist als keratolytische Behandlungsoption bei hyperkeratotischen Hauterkrankungen, wie z. B. Mollusca contagiosa, bereits etabliert.MethodikWirksamkeit und Verträglichkeit von KOH-5 %-Lösung zur Behandlung der leichten bis moderaten AK wurden in einer prospektiven, einarmigen, multizentrischen Medizinproduktestudie (Treatment of AK with KOH [TAKKOH]) untersucht. Die KOH-Lösung wurde 2‑mal täglich über 14 Tage aufgetragen mit anschließender Behandlungspause von 14 Tagen (≙ 1 Behandlungszyklus) für maximal 3 Behandlungszyklen oder mindestens bis zum Behandlungserfolg. Das primäre Zielkriterium „Behandlungserfolg“ wurde als komplette Remission (CR) aller AK-Läsionen eines Patienten definiert. Sekundäre Zielkriterien beinhalteten die Beurteilung der partiellen Remission (PR), der Anzahl an AK-Läsionen in Remission, die Wirksamkeitsbeurteilung anhand von Schulnoten durch Prüfärzte und Patienten sowie sicherheitsrelevante Endpunkte.ErgebnisseEs wurden 73 Patienten in die Studie eingeschlossen. Eine CR wurde von 54,9 % der Patienten erreicht, eine PR von 64,8 % bei einer Reduktion der Gesamtzahl an Läsionen um 69,9 %. Bei 46,6 % der Patienten wurden unerwünschte Ereignisse beobachtet. Diese überwiegend unerwünschten Wirkungen (82,6 %) stellten ausnahmslos transiente und milde lokale Hautreaktionen dar.SchlussfolgerungDie Studie liefert Hinweise auf die Wirksamkeit und Sicherheit von KOH-5 %-Lösung zur läsionsgerichteten topischen Therapie der AK.

P3.163 Hepatitis B and Hepatitis C Virus Prevalence Among Sexually Transmitted Disease Patients in Farwania Region of Kuwait

Background HBV and HCV share similar modes of transmission including the sexual route. This study was conducted to determine the prevalence of HBV and HCV infections among STD patients in Farwaniya region of Kuwait. Methods 1298 patients (1240 M, 58 F) presenting with history and/or signs and symptoms suggestive of an STD, seen over a period of one-year (January 2012 to December 2012) presenting to Farwania hospital dermatology department were included. Serology for HBV, HCV, HIV, and syphilis were done in all patients. HBV and HCV serology were performed in 1148 age and sex matched controls also, attending the same clinic with non-STD dermatological conditions. Results Mean age + SD of patients was 33.91+9.70 years (Age range: 19–58 years). Majority of the patients were heterosexual (99.6%). No history of blood transfusion, surgery, hospitalisation, parenteral drug use or traditional healing practises was found in any of the patients. Urethral discharge was the most common diagnosis (584), followed by genital warts (306), genital herpes (175), mollusca contagiosa (69) and syphilis (8). History of sexual encounter with concern/suspicion for an STD was reported by 166 patients. Most of the patients were expats. H/o recent travel was present in 159 patients. HCV was detected in 12/1298 patients (0.92%) and 6/1148 controls (0.52%). Serology for HBV and HIV were negative in all patients as well as controls. Discussion Sexual transmission of HCV is low and controversial especially among monogamous heterosexuals. It is being recognised as an emerging STD among HIV positive homosexuals. Detection of HCV among more number of STD patients (0.92%) without other risk factors, compared to non-STD dermatology patients (0.52%) in Farwania, Kuwait emphasises that sexual transmission of HCV is possible. Conclusion Patients with STDs are at risk for HCV infection and should be tested for HCV serology during their work-up.

Pulsed dye laser: what's new in non‐vascular lesions?

In dermatology, the pulsed dye laser (PDL) is the therapeutic instrument of choice for treating most superficial cutaneous vascular lesions. In addition, clinical experience over the last decade allowed us to treat patients with an ever increasing number of non-vascular indications. The purpose of this report is to summarize and critically appraise the scientific evidence that support the role of PDL in treating non-vascular skin lesions. A literature-based study has been conducted, including the review of publications over the period January 1995 to December 2006, using the Medline Database. We also included our own experience in managing non-vascular lesions with the PDL. Four sets of preoperative and postoperative photos are presented. For viral skin lesions, PDL proved to be an alternative to other therapy options. This applies particularly to periungual warts and mollusca contagiosa. The mechanism of PDL with inflammatory dermatoses has not yet been elucidated. The effect seems to be better if there is a vascular component to the disease. With most of these indications (such as psoriasis and acne), PDL currently plays a rather minor or complementary role. Regarding collagen remodelling (hypertrophic scars, keloids, stretch marks, and skin rejuvenation), the question of whether a therapy makes sense or not has to be decided from case to case. With PDL, it is possible to achieve good results with numerous, partly less well-known indications (i.e. lupus erythematosus). With other diseases, PDL has so far been considered to be a complementary therapy method or to be in an experimental state.

Attenuated ubiquitination of molluscum bodies in agminated mollusca contagiosa associated with malignant lymphoma

Attenuated ubiquitination of molluscum bodies in agminated mollusca contagiosa associated with malignant lymphoma

Viral lesions of the mouth in HIV-infected patients.

Viral lesions of the mouth in patients with HIV infection are common and these diseases any be a marker for HIV and disease progression. We review the spectrum of oral viral manifestations and discuss treatment modalities. The most common Epstein-Barr virus (EBV)-induced disorder in HIV-infected patients is oral hairy leukoplakia. EBV-related oral B-cell and T-cell lymphoma in AIDS patients has been described repeatedly. Herpes virus type 1 and rarely type 2 may lead to painful and resistant oral ulcers, and systemic treatment with acyclovir, valaciclovir or famciclovir is indicated. In acyclovir-resistant cases foscarnet is the treatment of choice. In recent years it has been documented that Kaposi's sarcoma, which often affects oral mucosa, is probably induced by herpesvirus type 8. Cytomegalovirus was found in 53% of cases with herpesviridae-induced mucosal ulcers as the only ulcerogenic viral agent in AIDS patients. In severe cytomegalovirus infection treatment with ganciclovir is helpful. Viral warts induced by different HPV may occur in the mouth. Several physical treatment modalities are possible in the oral mucosa. In AIDS patients mollusca contagiosa may occur as large and atypical lesions in the face and lips and rarely in the oral cavity. Cryotherapy is a bloodless treatment in such patients.

Molluscum contagiosum Mimicking Sebaceous Nevus of Jadassohn, Ecthyma and Giant Condylomata acuminata in HIV-lnfected Patients

We report on three HIV-infected homosexual male patients with atypical manifestations of mollusca contagiosa (MC). Their clinical presentation mimicked sebaceous nevus of Jadassohn, ecthyma and giant condylomata acuminata. HIV-infected patients feature MC with atypical morphology in about two thirds of the cases. The atypical aspects of MC concern the localization, morphology, growth pattern and size of the lesions. MC is a late manifestation of HIV infection and mirrors marked cellular immune deficiency. We conclude that in HIV-infected patients all tumorous lesions should be biopsied because the clinical characteristics are often not specific enough for a definite diagnosis.

Epidermal Langerhans cells, dermal dendritic cells, and keratinocytes in viral lesions of skin and mucous membranes: an immunohistochemical study

We wanted to evaluate the eventual expression of viral antigens and MHC class II products by keratinocytes as well as the alterations of epidermal Langerhans cells and dermal dendritic cells in viral lesions of skin and mucous membranes. Therefore we investigated 68 biopsy specimens of protracted viral lesions, such as warts, condylomas, and mollusca contagiosa, and of rapidly resolving viral lesions such as herpes simplex virus infection. For this we used immunohistochemical staining techniques and several monoclonal and polyclonal antisera. In most cases investigated viral antigens (human papilloma virus antigens or herpes simplex virus type 1 antigens) could be demonstrated in keratinocytic nuclei. Except for a few viral lesions in which epidermal Langerhans cells were rather numerous, epidermal Langerhans cells were reduced in number or absent in almost all viral lesions. Moreover, epidermal Langerhans cells and dermal dendritic cells showed changes in morphology, distribution, and immunophenotype. These alterations may be caused by a toxic effect of the virus on dendritic cells. HLA-DR+ keratinocytes could be identified in few viral lesions only; HLA-DQ+ keratinocytes were not seen. Possible explanations for this lack of MHC class II expression by keratinocytes are discussed.

Mollusca contagiosa multiples révélateurs d’une infection à HTLV III

We report here a case of cutaneous molluscum contagiosum infection, which led to the diagnosis of HTL V III infection. Profuse mollusca contagiosa are one of the cutaneous lesions indicating the presence of AIDS at any stage.

A cholesteatoma chronicle.

The special kind of keratoma found in the temporal bone, which has been called cholesteatoma by our otologic forefathers, was an unsolved problem in Virchow's time. It still is. I feel that a careful scrutiny of some classic words concerning cholesteatoma is in order. In doing so, I will paraphrase the late great philosopher, George Santayana, who stated: He who is unaware of the past is condemned to relive it and repeat it. Von Troltch, 1 107 years ago (Fig 1), gave an early account of Virchow's examinations of the cholesteatoma, or the molluscous tumors of J. Muller, or Mollusca Contagiosa as termed by Toynbee, which occur in the petrous bone. Virchow advises the substitution of the original name ( Perlgeschewulste )— pearl tumors, which are shining, onion-like, layered tumors, in the posterior secretion of the temporal bone, which extended through the bone to the external auditory canal —sometimes, also, in

New Methods of Resuscitation

<h3>Background</h3> HBV and HCV share similar modes of transmission including the sexual route. This study was conducted to determine the prevalence of HBV and HCV infections among STD patients in Farwaniya region of Kuwait. <h3>Methods</h3> 1298 patients (1240 M, 58 F) presenting with history and/or signs and symptoms suggestive of an STD, seen over a period of one-year (January 2012 to December 2012) presenting to Farwania hospital dermatology department were included. Serology for HBV, HCV, HIV, and syphilis were done in all patients. HBV and HCV serology were performed in 1148 age and sex matched controls also, attending the same clinic with non-STD dermatological conditions. <h3>Results</h3> Mean age + SD of patients was 33.91+9.70 years (Age range: 19–58 years). Majority of the patients were heterosexual (99.6%). No history of blood transfusion, surgery, hospitalisation, parenteral drug use or traditional healing practises was found in any of the patients. Urethral discharge was the most common diagnosis (584), followed by genital warts (306), genital herpes (175), mollusca contagiosa (69) and syphilis (8). History of sexual encounter with concern/suspicion for an STD was reported by 166 patients. Most of the patients were expats. H/o recent travel was present in 159 patients. HCV was detected in 12/1298 patients (0.92%) and 6/1148 controls (0.52%). Serology for HBV and HIV were negative in all patients as well as controls. <h3>Discussion</h3> Sexual transmission of HCV is low and controversial especially among monogamous heterosexuals. It is being recognised as an emerging STD among HIV positive homosexuals. Detection of HCV among more number of STD patients (0.92%) without other risk factors, compared to non-STD dermatology patients (0.52%) in Farwania, Kuwait emphasises that sexual transmission of HCV is possible. <h3>Conclusion</h3> Patients with STDs are at risk for HCV infection and should be tested for HCV serology during their work-up.