Professional Documents
Culture Documents
Bacteria
Fungus
Parasite
Virus
Bacteria
Fungus
Parasite
Virus
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A herpes virus
A pox virus
Human immunodeficiency virus
Human papillomavirus
Varicella-zoster virus
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A herpes virus
A pox virus
Human immunodeficiency virus
Human papillomavirus
Varicella-zoster virus
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Molluscum Contagiosum
Molluscum contagiosum (MC) is a benign, usually
asymptomatic viral infection of the skin with no
systemic manifestations
Usually is characterized by 2 to 20 discrete, 5mm-diameter, flesh-colored to translucent, domeshaped papules, some with central umbilication
Lesions commonly occur on the trunk, face, and
extremities but are rarely generalized
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Molluscum Contagiosum
An eczematous reaction encircles lesions in approximately
10% of patients
Three groups of people are primarily affected:
Young children, especially those with atopy
Sexually active adults
Immunosuppressed individuals
People with eczema and
immunocompromising
conditions have more
widespread and prolonged
eruptions.
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Cantharidin
Cryotherapy
Curettage
No treatment because it may resolve on its own
All of the above are options
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Treatment Principles
Children with atopy are
less likely to clear on
their own
Scratching can spread
the lesion in a linear
mode (Koebner
phenomenon)
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Treatment Principles
There is no consensus on the management of MC in
children and adolescents
Therapy may be warranted to:
Treatment Options
First-line treatments include:
Cantharidin a vesicant that causes blistering
on the applied area (not painful when applied)
Curettage scraping to remove
Cryotherapy liquid nitrogen therapy
Topical retinoids (the same ones we use in
acne)
Imiquimod a cream that stimulates the
immune system
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Referral Information
Refer a patient with MC to a dermatologist if:
Recalcitrant/prolonged cases
Diffuse involvement
Extensive facial involvement
Significant discomfort
Coexisting severe dermatitis
Immunocompromised
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Blisters
Color change
Pain
Scarring
All of the above
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Blisters
Color change
Pain
Scarring
All of the above
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Molluscum Transmission
Spread via skin-to-skin contact, fomite exposure, and
autoinoculation
Associated with public water exposures (pools, bath
houses, hot tubs)
Wrestlers are particularly at risk because of prolonged skin
contact and friction
MC should not prevent a child from attending child care or
school or from swimming in public pools
When possible, lesions not covered by clothing should be
covered by a watertight bandage. The bandage should be
changed daily or when soiled.
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Henderson-Paterson Bodies
Henderson-Patterson
Bodies, aka Molluscum
bodies
Intracytoplasmic inclusion
bodies, containing poxvirus
particles, seen in
keratinocytes
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Molluscum Contagiosum in
Immunosuppressed Patients
Adults with chronic MC outside the genital area should
be evaluated for immunosuppression
Patients with untreated HIV often have lesions
concentrated on the face or genitalia. Oral and genital
mucosa may be involved
Giant lesions can occur
HAART leads to clearance but
may have lag time before
improvement is seen
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Acknowledgements
This module was developed by the American Academy
of Dermatology Medical Student Core Curriculum
Workgroup from 2008-2012.
Primary authors: Susan K. Ailor, MD, FAAD; Kari L.
Martin, MD.
Peer reviewers: Timothy G. Berger, MD, FAAD;
Brandon D. Newell, MD; Maria C. Garzon, MD, FAAD.
Revisions and editing: Sarah D. Cipriano, MD, MPH;
Meghan Mullen Dickman.
Last revised March 2011.
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References
James WD, Berger TG, Elston DM. Chapter 19. Viral Diseases (chapter).
Andrews Diseases of the Skin Clinical Dermatology. 10th ed. Philadelphia, Pa:
Saunders Elsevier; 2006: 394-397.
Mancini AJ, Shani-Adir A. Chapter 80. Other Viral Diseases (chapter). Bolognia
JL, Jorizzo JL, Rapini R: Dermatology. 2nd ed. Mosby Elsevier; 2008. 1229-1233.
van der Wouden JC, et al. Interventions for cutaneous molluscum contagiosum.
Cochrane Rev. Vol 2. 2010.
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