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A case of molluscum contagiosum.

Molluscum contagiosum is a benign contagious disease caused by a poxvirus. The virus proliferates within keratinocytes and forms intracytoplasmic Molluscum bodies. Though it is a common clinical condition, histologically is not yet reported from this region of Mymensingh. We received a skin biopsy specimen in a pathology laboratory for histological examination. The Haematoxylin and Eosin stained sections revealed typical intracytoplasmic Molluscum bodies in keratinocytes. The lesions were in the trunk, which is a common site for Molluscum Contagiosum (MC). As the diagnosis of Molluscum contagiosum is easy by histological examination, every patient suspected to be this disease is recommended to be examined histologically to exclude other similar types of lesions.

Adult↗

Keloid scars as a result of CO2 laser for molluscum contagiosum.

Molluscum contagiosum is an infectious disease of the skin, found primarily on the thighs and genitalia. It is a sexually transmitted disease of increasing prevalence. The traditional treatment of this condition is surgical ablation, although CO2 laser has been advocated recently as an alternative mode of therapy. Six patients with molluscum contagiosum were treated by either continuous or intermittent CO2 laser. Four of the six have developed severe keloid scars. Removal of lesions by cold knife, however, was not followed by keloid scars. In the same patient, areas affected by human papillomavirus that were treated with CO2 laser did not develop keloid scars. Our results question the use of CO2 laser therapy for molluscum contagiosum.

Adult↗

Molluscum contagiosum.

Molluscum contagiosum, a benign cutaneous infection of children and young adults, occurs throughout the world. Infectious virions apparently are transferred from the visible lesions to the skin of susceptible persons, either by direct contact or by fomites. Circumstantial evidence suggests that this infection is transmitted between young adults during sexual intercourse. The lesions of molluscum contagiosum are usually small, firm, umbilicated papules located on exposed skin of children or on genital skin in young adults. Such lesions are pathognomonic. Molluscum lesions resolve spontaneously; however, various treatments that remove the infected epidermis may be used to minimize transmission of the disease or for cosmetic reasons. In vitro culture techniques that have been successful for other viruses fail to propagate this virus. Successful inoculations of humans were reported early in the 20th century, but attempts to repeat these experiments have failed. Consequently, precise knowledge of this infection is lacking.

Adolescent↗

Molluscum contagiosum.

Molluscum contagiosum is a disease caused by a poxvirus of the Molluscipox virus genus that produces a benign self-limited papular eruption of multiple umbilicated cutaneous tumors. This common viral disease is confined to the skin and mucous membranes. Transmission requires direct contact with infected hosts or contaminated fomites. It is generally thought to infect humans exclusively, but there are a few isolated reports of Molluscum contagiosum occurring in chickens, sparrows, pigeons, chimpanzees, kangaroos, a dog, and a horse. The infection is found worldwide and has a higher incidence in children, sexually active adults, and those who are immunodeficient.

Incidence↗

Molecular epidemiology of Australian isolates of molluscum contagiosum.

Molluscum contagiosum lesions obtained from 75 Australian patients, 22 (29%) of whom were HIV positive, were examined by restriction endonuclease analysis and Southern blot hybridisation using radiolabelled and digoxigenin-labelled MCV DNA probes. The isolates were classified (MCV 1, 1v, 2, and 2v) on the basis of these results, which were in turn correlated with the clinical features of each lesion. A total of 44 (59%) of the lesions contained MCV 1 or 1v, 24 (32%) contained MCV 2 or 2v, three (4%) contained multiple MCV types, whereas four (5%) of lesions submitted contained no detectable MCV DNA. The ratio of MCV 1/1v to MCV 2/2v was determined to be approximately 1.75:1. There were substantial differences between the distribution of MCV types 1 and 2 among patients of different age groups, but no significant relationship between MCV type and the sex of the patient was found. MCV 2 was more frequently detected in lesions from anogenital areas and in immunosuppressed (HIV-positive) patients, and MCV 1 was more commonly isolated from skin rather than genital lesions, but neither association was statistically significant. Fragment F (10 kbp) obtained from the genome of MCV 1 was capable of differentiating MCV 1 from MCV 2 when used as a probe in hybridisation experiments with BamHI cut samples and may be useful when small amounts of lesion prevents differentiation by direct visualisation of restriction endonuclease fragments.

Adult↗

[Molluscum contagiosum].

Molluscum contagiosum is a common disease of the skin caused by a virus of the pox group, most commonly seen in children. The lesion is very rare in the oral cavity, since review of the English literature revealed only 5 documented cases. Oral lesions have no pathognomic clinical picture and may cause diagnostic problems.

Child, Preschool↗

Intraoral molluscum contagiosum.

Molluscum contagiosum (MC) presenting as a self-limiting disease of the skin is not uncommon. To date, however, documented cases of MC of the oral cavity have been rare. A case of MC of the palate of a 52-year-old man is reported. The clinical and histopathologic features of this uncommon oral lesion are discussed, and the literature is reviewed.

Humans↗

An update on molluscum contagiosum.

Molluscum contagiosum is a common viral infection of the skin, and occasionally the mucous membranes, manifesting as benign tumors. The characteristic appearance is of pearly, umbilicated papules. The disease is self-limited in immunocompetent hosts, but may be protracted in those who are immunocompromised. Multiple local therapeutic options are available; the use of systemic agents has been reported in recalcitrant cases or in patients in whom topical therapy is difficult to apply.

Adolescent↗

Double-blind, randomized, placebo-controlled trial of the use of topical 10% potassium hydroxide solution in the treatment of molluscum contagiosum.

Molluscum contagiosum is a common viral infection of the skin that frequently affects children. Lesions take between 6 and 18 months to resolve spontaneously and are a source of great embarrassment to both caretakers and children, often affecting attendance at school and limiting social activity. Treatment options to date have been poorly tolerated by children but recent studies have suggested that potassium hydroxide may be beneficial. This double-blind, randomized, placebo-controlled study compared 10% potassium hydroxide with placebo (normal saline). Twenty patients, aged 2 to 12 years, were recruited. Parents applied a solution twice daily to lesional skin until signs of inflammation appeared. Children were examined by the same observer on days 0, 15, 30, 60, and 90. Seventy percent of children receiving topical potassium hydroxide cleared, compared with 20% in the placebo group. Further dosing studies are required to identify whether weaker concentrations of potassium hydroxide are as efficacious, with less irritancy.

Administration, Cutaneous↗

Molluscum Contagiosum.

Molluscum contagiosum is described as an easily treated benign viral disease of the skin. Treatments detailed include cryosurgery and curettage-the treatments of choice-and podophyllotoxin and tretinoin. History and virology also are outlined.

Journal Article↗

Interventions for cutaneous molluscum contagiosum.

BACKGROUND: Molluscum contagiosum is a common skin infection, caused by a virus, which will usually resolve within months in people with a normal immune system. Many treatments have been promoted for molluscum contagiosum but a clear evidence base supporting them is lacking. OBJECTIVES: To assess the effects of management strategies (including waiting for natural resolution) for cutaneous, non-genital molluscum contagiosum in healthy people. SEARCH STRATEGY: We searched the Skin Group Specialised Register (March 2004), the Cochrane Central Register of Controlled Trials (2004, Issue 2), MEDLINE (from 1966 to March 2004), EMBASE (from 1980 to March 2004) and LILACS (from 1982 to March 2004) databases. We also searched reference lists and contacted pharmaceutical companies and experts in the field. SELECTION CRITERIA: Randomised controlled trials for treatment of molluscum contagiosum were investigated. Trials on sexually transmitted molluscum contagiosum and in people with lowered immunity (including those with HIV infection) were excluded. DATA COLLECTION AND ANALYSIS: Study selection and assessment of methodological quality were carried out by two independent authors. As similar comparisons between two interventions were not made in more than one study, statistical pooling was not performed. MAIN RESULTS: Five studies, with a total number of 137 participants, examined the effects of topical (three studies), systemic and homoeopathic interventions (one study each). Limited evidence was found for sodium nitrite co-applied with salicylic acid compared to salicylic acid alone (risk ratio (RR) 3.50, 95% confidence interval (CI) 1.23 to 9.92). No statistically significant differences were found for topical povidone iodine plus salicylic acid compared to povidone iodine alone (RR of cure 1.67, 95% CI 0.81 to 3.41) or compared to salicylic acid alone. Also no statistically significant differences were found for potassium hydroxide compared to placebo; systemic treatment with cimetidine versus placebo or systemic treatment with calcarea carbonica, a homoeopathic drug, versus placebo (RR 5.57, 95% CI 0.93 to 33.54). Study limitations included no blinding (two studies), many dropouts (three studies) and no intention-to-treat analysis (two studies); small study sizes may have led to important differences being missed. None of the evaluated treatment options were associated with serious adverse effects. AUTHORS' CONCLUSIONS: No single intervention has been shown to be convincingly effective in treating molluscum contagiosum.

Anti-Infective Agents, Local↗

An immunohistochemical study of abnormal keratinocyte proliferation in molluscum contagiosum.

BACKGROUND: Molluscum contagiosum is a common cutaneous tumour that is characterized by usually spontaneous involution and self-limited spreading in immunocompetent individuals. OBJECTIVE: We aimed to investigate the apoptosis and the expression of cell-cycle proteins in molluscum contagiosum lesions. METHODS: The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling (TUNEL)-based apoptotic index and the expression of the cell-cycle proteins Ki-67, p53, p21WAF and Bcl-2 were investigated in molluscum contagiosum lesions obtained from the trunk of 20 immunocompetent patients and in normal skin samples from the trunk of six healthy volunteers. RESULTS: Whereas molluscum contagiosum lesions displayed a TUNEL-based apoptotic index similar to that of normal skin, they exhibited an increased Ki-67 index, which was confined to the basal and first suprabasal layers (P < 0.001). Compared with normal non-sun-exposed skin, molluscum contagiosum lesions also exhibited increased p53 staining in basal cells (P < 0.01), increased p21WAF in suprabasal cells (P < 0.001) and loss of Bcl-2 expression. CONCLUSIONS: These results indicate that molluscum contagiosum lesions exhibit an increased proliferation rate of keratinocytes, which is likely to be partially counteracted by accumulation of p53.

Apoptosis↗

Molecular epidemiologic analysis of Japanese patients with molluscum contagiosum.

BACKGROUND: Molluscum contagiosum virus (MCV) causes molluscum contagiosum (MC) in both children and adults. Recent studies have revealed that the DNA of MCV can be classified into two major types by restriction enzyme cleavage patterns; however, the relationship between MCV types and the clinical features has not been fully understood. Our study was conducted to examine whether there are geographic differences in the incidence of MCV types and whether a correlation exists between MCV types and the age, sex, and clinical status of the patients. METHODS: Specimens were obtained from 171 Japanese patients. The total DNA was extracted and digested with the restriction enzymes, BamH I, Hind III, and Cla I, respectively. Specimens were then electrophoresed in agarose gels. The gels were stained with ethidium bromide and photographs were taken under transillumination. RESULTS: Six different cleavage patterns were observed; they were classified into two major types, MCV 1 and MCV 2, consisting of two MCV 1-variants, and MCV 2 prototype, and three MCV 2-variants. The ratio of MCV 1 to MCV 2 was 13:1. MCV 1 was commonly detected in children (98%) and adult women (92%). MCV 2 was more frequently isolated from adult men (44%) and from patients with human immunodeficiency virus (HIV) infection (75%). CONCLUSION: MCV types found in Japanese children and adult women were predominantly MCV 1 and less frequently MCV 2. This pattern is similar to that observed in European countries and Australia, suggesting a high frequency and world-wide distribution of MCV 1. The higher incidence of MCV 2 among adult men and HIV-positive patients may indicate that transmission routes of MCV 1 and MCV 2 is somewhat different, of which the latter may be in part by sexual contact.

Adolescent↗

Replication of molluscum contagiosum virus.

Molluscum contagiosum virus (MCV) infects preadolescent children and sexually active adults, frequently causing a disfiguring cutaneous disease in immunosuppressed HIV-infected individuals. The development of an efficacious treatment regime has been hampered by the failure to replicate the virus in the laboratory. Here we report the first demonstration of MCV replication in an experimental system. In human foreskin grafts to athymic mice, MCV induced morphological changes which were indistinguishable from patient biopsies and included the development and migration of molluscum bodies containing mature virions to the epidermal surface.

Animals↗

Molecular cloning of a novel CC chemokine, interleukin-11 receptor alpha-locus chemokine (ILC), which is located on chromosome 9p13 and a potential homologue of a CC chemokine encoded by molluscum contagiosum virus.

Molluscum contagiosum virus (MCV) encodes a CC chemokine MC148R which is likely to have been acquired from the host. By a homology search employing MC148R as a probe, we have identified a novel CC chemokine whose gene exists next to the IL-11 receptor alpha (IL-11Ralpha) gene in both humans and mice. Thus, this chemokine maps to chromosome 9p13 in humans where IL-11Ralpha has been assigned. We term this novel chemokine IL-11Ralpha-locus chemokine (ILC). ILC has the highest homology to MC148R among the known human CC chemokines. Furthermore, ILC is strongly and selectively expressed in the skin where infection of MCV also takes place. Thus, ILC is likely to be the original chemokine of MC148R.

Amino Acid Sequence↗