Figure 1067

Molluscum contagiosum is an infection of the skin caused by the molluscum contagiosum virus, a member of the pox virus family. Molluscum does not grow in culture or infected laboratory animals. Manifestations are pearly, pink, dome-shaped, glistening, firm lesions; in immunosuppressed patients, however, they may be over 1 cm in diameter and multiple lesions may occur together. The infection usually lasts up to 2 months in immunocompetent patients, but a chronic, recalcitrant, and disfiguring infection may occur in immunosuppressed patients. The virus is contracted and spreads via close contact with an infected person, fomites, or via autoinoculation. The incubation period is 2 weeks to 6 months. The diagnosis is made visually or by direct examination of curet-tings from the center of the lesion showing molluscum intracytoplasmic inclusion bodies. Treatment is started for the prevention of spreading, to relieve symptoms, and for cosmetic reasons. Treatment includes cryothera-py, curettage, podophyllin, cantharidin, trichloroacetic acid, phenol, salicylic acid, strong iodine solutions, lactic acid, tretinoin, silver nitrate, and interferon alpha topical or intralesional, and possibly oral cimetidine, with adhesive tape occlusion. None of the available treatments result in a rapid or definite clearance in the immunosuppressed patient. Treatment of the underlying retro-virus infection has been shown to help in AIDS patients, and perhaps reviewing the degree of immunosuppression in the transplant patient will help. A, Molluscum conta-giosum papule. Note pearly umbilicaled appearance. B, Histologic slide of molluscum showing a cross section of the papule. C, Close-up view of the molluscum bodies.

0 0

Post a comment