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21 Molluscum Contagiosum PDF
21 Molluscum Contagiosum PDF
21
Molluscum contagiosum is a viral tumor, WR FP 7KH\ DUH DW ÀUVW ÀUP VROLG DQG ÁHVK
caused by a DNA-containing poxvirus. Mollus- colored. However, as they mature, they tend to
cum contagiosum virus (MCV) is a brick-shaped become softened and pearly white in color (Figs
particle, 300 × 200 × 100 nm in size. It replicates 21.1 A and B). Some lesions may suppurate.
in aggregates within the cytoplasm of the infec- They are distributed over the face, hands, lower
ted cells. Basal cell proliferation and epidermal abdomen, and genitalia. The mucous memb-
transit time are increased in infected epidermis. ranes of the lip, tongue, and buccal mucosa may
also be affected. The lesions are usually a few,
CLINICAL FEATURES at times they may be multiple. They are asymp-
Molluscum contagiosum is characterized by tomatic. Gigantic lesions of size 1 cm or more,
dome-shaped, waxy pink papules or nodules PD\RFFDVLRQDOO\GHYHORSLQÁDPPDWLRQ5DUHO\
2 to 5 mm in size. Central umbilication is its the lesions may become horny (molluscum
hallmark. Some lesions may attain a size up contagiosum carnuatum).
A B
Figures 21.1A and B: Pearly-white, umbilicated papules
Molluscum Contagiosum 99
The disease is contracted by direct con- Microscopic examination of hematoxylin—
tact with infected skin, and by autoinocula- eosin stained section reveals, an acanthoma with
tion. It may also be transmitted sexually. It downward proliferation of rete-ridges, and en-
affects children, and young adults. Incubation velopment by connective tissue to form a deep
period ranges from 2 to 3 weeks. Immuno- crater. The cytoplasm of the prickle cell contains
suppression secondary to drugs like corti- numerous small eosinophilic and later basophil-
costeroids, methotrexate, and infection with ic inclusion bodies called molluscum-bodies, or
KXPDQ LPPXQRGHÀFLHQF\ YLUXV +,9 PD\ Henderson-Patterson bodies. Their bulk com-
predispose to widespread and recalcitrant presses the nucleus to the side of the cell. A fully
molluscum contagiosum. It usually runs a developed lesion depicts a crater near the sur-
self-limiting course of 6 to 9 months, but oc- face, which extends into the lobules. The crater
casionally the lesions may persist for months contains the hyalinized molluscum bodies.
or years.
TREATMENT
DIAGNOSIS The following modalities are useful:
Pearly-white, dome shaped papule or nodule 5HPRYDORIWKHOHVLRQZLWKDVKDUSFXUHWWH
with central umbilication is distinctive. Dia- &U\RWKHUDS\ZLWKOLTXLGQLWURJHQRUGU\LFH
JQRVLV PD\ EH FRQÀUPHG E\ LQFLVLQJ RQH RI (OHFWURGHVLFFDWLRQ
the papules, squashing the contents between
two glass slides and staining it with Wright’s RECOMMENDED READING
or Giemsa’s stain. Examination under a 1. Brown ST, Nalley JF, Kraus JF. Molluscum con-
tagiosum: a review, Sex Transm Dis 1981;8:227-234.
low power of the microscope reveals ovoid, 2. Porter CD, Muhleman MF, Cream JJ et al.
smooth-walled, homogenous cytoplasmic Molluscum contagiosum: Characterization of
masses consisting of mature, immature, and viral DNA and clinical features. Epidemiol Infect
1987; 99:563-566.
incomplete virions along with cellular debris. 5HHG-3DUNLQVRQ537KHKLVWRJHQHVLVRIPROOXV-
They measure 25 nm in diameter. cum contagiosum. Am J Surg Pathol 1983;1:161-166.