Molluscum contagiosum Flashcards
caused by
4 poxvirus
MCV1-4.
mosy common cause
MCV-1 most common worldwide
in small children all are caused by mcv1
in pxs infected w HIV, most common virus
MCV2- majority of infections (60%)
these three grps are primarily infected
young children(age 1-4)
Sexually active young adults 20-29 yo
immunosuppressed
transmission
direct skin to skin contact
Small smokth surfaces firm dome shapes pearly paule ave 3-5mm in diameter. central umbilicatioj or central white core.
side lighting may help highlight the openjng in the top of the lesion.
most common inflamm response seen in 40% if affected children is
molluscum dermatitis. more commin un atopic children, it is a mild eczematous eruption surrounding the individual lesions.
histo
lesions primarily affect the follicular epithelium.
lesion is acanthotic and cup shaped.
cytoplasm of the prickle cells, numerous small eosinophilic and later basophilic inclusion bodies flrm called molluscum bodies. or henderson-Paternson bodies.
tx
duration of infectin- 12-18 mos.
individual lesions last 2-4 mos.
topical canthardin - body.
Cantharone is applied by the wooden end of a cotton swab only to the lesion and left on for 1-6 hours. 20 lesions can be tx per setting.
nicking w blade or needle.
light cryotx
tca 35-100%
topical tretinoin applied w a toothpick or q tip.
oral cimetidine- h2 antagonist- immunomodulatory effects benefit atopic pxs.
in pxs w ad, curettage and cryotx is most effective while least likely to exacerbate ad.
genital- cryotx or curettage.
partners examined for std.
beard- no blade razor, curettage, or core removal w the blade, comedo extractor is most effective.
in pxs w HIV, Continous app of tretinoin cream once nightly at the highest concentration tolerated may reduce the rate of appearance if new lesions.
topical cidofovir 1-3% applicatioj and systemic infusion may lead to dramatic resolution of molluscum in pxs w aids.
