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Edwards S, Boffa MJ, Janier M, Calzavara-Pinton P, Rovati C, Salavastru CM, Rongioletti F, Wollenberg A, Butacu AI, Skerlev M, Tiplica GS. 2020 European guideline on the management of genital molluscum contagiosum. J Eur Acad Dermatol Venereol 2020; 35:17-26. [PMID: 32881110 DOI: 10.1111/jdv.16856] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 01/05/2023]
Abstract
Molluscum contagiosum is a benign viral epidermal infection associated with high risk of transmission. The guideline is focused on the sexually transmitted molluscum contagiosum. The diagnosis is clinical with characteristic individual lesions, termed 'mollusca', seen as dome-shaped, smooth-surfaced, pearly, firm, skin-coloured, pink, yellow or white papules, 2 - 5 mm in diameter with central umbilication. Dermoscopy may facilitate diagnosis. Therapeutic options are numerous, including physical treatments (cautery, curettage and cryotherapy), topical chemical treatments (e.g. podophyllotoxin and imiquimod) or waiting for spontaneous resolution in immunocompetent patients. In pregnancy, it is safe to use physical procedures (e.g. cryotherapy). Immunosuppressed patients develop severe and recalcitrant molluscum lesions that may require treatment with cidofovir, imiquimod or interferon. Patients with molluscum contagiosum infection should be offered to be screened for other sexually transmitted infections.
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Affiliation(s)
| | - M J Boffa
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
| | - M Janier
- STD Clinic, Hôpital Saint-Louis AP-HP and Hôpital Saint-Joseph, Paris, France
| | | | - C Rovati
- Dermatology Department, University of Brescia, Italy
| | - C M Salavastru
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - F Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - A Wollenberg
- Dept. of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - A I Butacu
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - M Skerlev
- Zagreb University Hospital and Zagreb University School Of Medicine, Zagreb, Croatia
| | - G S Tiplica
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
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2
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Abstract
Poxvirus (PXV) infections are a common cause of cutaneous signs. In France, certain forms of poxvirus are frequent and benign (molluscum contagiosum), while others are rare but potentially serious (cowpox virus [CPXV]). Whereas only smallpox and molluscum contagiosum viruses have a human reservoir and are transmitted between humans, most poxvirus infections are zoonoses having only animal reservoirs. Only a small number of poxviruses are responsible for infection in humans, but the increasing number of new pets, some of which are exotic, coupled with the rapid rise in international travel are creating a greater risk of transmission of zoonotic PXV to new vectors and of spread of these diseases to new regions throughout the world. In France, molluscum contagiosum, orf and milkers' nodule give rise to numerous consultations and are well known to dermatologists. However, dermatologists must also be able to identify other parapoxviruses of similar presentation to orf; thus, CPXV and monkeypox are considered potentially emergent viruses with a high risk of epidemic and spread due to increasing international transport and the loss of the maximum protection against smallpox. Finally, despite its declared eradication, smallpox is currently being monitored because of the potential risk of reintroduction, whether accidentally or deliberately through bioterrorism.
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Affiliation(s)
- G Bohelay
- Service de dermatologie, Hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93009 Bobigny, France
| | - T-A Duong
- Service de dermatologie, Hôpital Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
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3
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Creytens D. Melan A Antibody Cross-Reactivity in Molluscum Contagiosum Bodies. Int J Surg Pathol 2017; 26:151-152. [PMID: 28805130 DOI: 10.1177/1066896917725805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David Creytens
- 1 Ghent University and Ghent University Hospital, Ghent, Belgium
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Eleftheriou LI, Kerr SC, Stratman EJ. Diagnosis of atypical molluscum contagiosum: the utility of a squash preparation. Clin Med Res 2011; 9:50-1. [PMID: 20974889 PMCID: PMC3064753 DOI: 10.3121/cmr.2010.953] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Lydia I. Eleftheriou
- University of Minnesota Medical School-Twin Cities, Minneapolis, MN
- Department of Dermatology, Marshfield Clinic, Marshfield, Wisconsin, USA
| | - Sarah C. Kerr
- Department of Dermatology, Marshfield Clinic, Marshfield, Wisconsin, USA
| | - Erik J. Stratman
- Department of Dermatology, Marshfield Clinic, Marshfield, Wisconsin, USA
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5
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Bauer JH, Miller OF, Peckham SJ. Medical Pearl: confirming the diagnosis of molluscum contagiosum using 10% potassium hydroxide. J Am Acad Dermatol 2007; 56:S104-5. [PMID: 17434028 DOI: 10.1016/j.jaad.2006.08.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2006] [Revised: 08/11/2006] [Accepted: 08/18/2006] [Indexed: 11/17/2022]
Affiliation(s)
- Jacob H Bauer
- Geisinger Medical Center, Danville, Pennsylvania, USA.
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6
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Abstract
The poxvirus family is a diverse and interesting group of viruses that affect both humans and animals. Poxviruses are epitheliotropic and therefore are of interest to the dermatologist. The genera of poxviruses known to affect humans are Orthopoxvirus, Parapoxvirus, Molluscipoxvirus, and Yatapoxvirus. The different poxviruses are reviewed, including their history, incidence, clinical presentation, and treatment.
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Affiliation(s)
- D G Diven
- Department of Dermatology, University of Texas Medical Branch, Galveston, TX, USA
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7
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Bugert JJ, Darai G. Recent advances in molluscum contagiosum virus research. ARCHIVES OF VIROLOGY. SUPPLEMENTUM 1997; 13:35-47. [PMID: 9413524 DOI: 10.1007/978-3-7091-6534-8_4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Molluscum contagiosum virus (MCV) and variola virus (VAR) are the only two poxviruses that are specific for man. MCV causes skin tumors in humans and primarily in children and immunocompromised individuals. MCV is unable to replicate in tissue culture cells or animals. Recently, the DNA sequence of the 190 kbp MCV genome was reported by Senkevich et al. MCV was predicted to encode 163 proteins of which 103 were clearly related to those of smallpox virus. In contrast, it was found that MCV lacks 83 genes of VAR, including those involved in the suppression of the host response to infection, nucleotide biosynthesis, and cell proliferation. However, MCV possesses 59 genes predicted to code for novel proteins including MHC-class I, chemokine and glutathione peroxidase homologs not found in other poxviruses. The MCV genomic data allow the investigation of novel host defense mechanisms and provide new possibilities for the development of therapeutics for treatment and prevention of the MCV infection.
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Affiliation(s)
- J J Bugert
- Institut für Medizinische Virologie, Universität Heidelberg, Federal Republic of Germany
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8
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Forghani B, Oshiro LS, Chan CS, Hurst JW, Dennis J, Darai G, Warford AL, Cohen RM. Direct detection of Molluscum contagiosum virus in clinical specimens by in situ hybridization using biotinylated probe. Mol Cell Probes 1992; 6:67-77. [PMID: 1545832 DOI: 10.1016/0890-8508(92)90073-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Molluscum contagiosum virus (MCV) is an unclassified poxvirus which has recently become recognized as causing a major sexually transmitted disease. At present no assay is available for specific detection of MCV because the virus cannot be serially propagated in cell culture. Since MCV produces an abortive, limited growth with some cytopathic effect in certain cell lines, we were able to develop an in situ hybridization assay for detection of MCV genome in clinical specimens. Human fetal diploid lung cell monolayers were infected with clinical specimens, and after proper incubation and fixation in paraformaldehyde, hybridization was performed under full stringency conditions with a molecularly cloned biotinylated probe. Only MCV infected cells showed homology to the MCV probe with a purple-brown cytoplasmic staining. Additionally, we have described an in situ hybridization assay for direct detection of MCV genome in formalin-fixed, paraffin-embedded biopsies. Characteristic intracytoplasmic Molluscum bodies (Henderson-Paterson bodies) were detected in stratum spinosum cells of the epidermis. Striking staining similarities have been observed between in situ hybridization and haematoxylin-eosin cytostaining. These procedures are the first successful identification of MCV genome in clinical samples by molecular hybridization, with sensitivity and specificity equal to or greater than electron microscopy.
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Affiliation(s)
- B Forghani
- Viral and Rickettsial Disease Laboratory, California State Department of Health Services, Berkeley
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Hurst JW, Forghani B, Chan CS, Oshiro L, Darai G. Direct detection of molluscum contagiosum virus in clinical specimens by dot blot hybridization. J Clin Microbiol 1991; 29:1959-62. [PMID: 1774321 PMCID: PMC270242 DOI: 10.1128/jcm.29.9.1959-1962.1991] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A dot blot hybridization protocol was developed for the direct detection of molluscum contagiosum virus (MCV) DNA in clinical specimens submitted for virus isolation. Samples were concentrated by high-speed centrifugation and treated with proteinase K; this was followed by a single phenol-chloroform extraction step. The DNA was denatured, and the entire volume was spotted onto a nitrocellulose membrane. A biotinylated DNA probe specific for the BamHI-C region of MCV type 1 was used for hybridization. Evidence of MCV DNA was visualized by using streptavidin alkaline phosphatase conjugate and 5-bromo-4-chloro-3-indolyl phosphate-nitroblue tetrazolium as the substrate. Results showed that nonspecific hybridization does not occur with herpes simplex virus- or orf virus-infected clinical specimens and that dot blotting is more sensitive and reproducible than electron microscopy.
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Affiliation(s)
- J W Hurst
- Viral and Rickettsial Disease Laboratory, California State Department of Health Services, Berkeley 94704
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10
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Abstract
This article reviews the recent English language literature on dematopathology, with an emphasis on publications appearing between January 1986 and July 1987. Immunohistochemistry continues to grow in importance as a diagnostic as well as a research technique. The advent of in situ deoxyribonucleic acid hybridization technology has raised diagnostic accuracy to a new level; it has already proved valuable in the diagnosis of certain viral infections. Areas that have received particular attention include phenotypic characteristics of lymphomas and lymphoma-like conditions, congenital melanocytic nevi and malignant melanoma, neuroendocrine carcinoma and other small cell tumors of the skin, sweat gland carcinomas, and eosinophil and its associated diseases, and unusual infectious diseases involving the skin.
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Affiliation(s)
- J W Patterson
- Department of Pathology, Medical College of Virginia, Richmond 23298
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11
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Abstract
Biopsies of morpheaform basal cell carcinomas (MBCCs) were separated into 2 groups based on histological features: 1) a pure morpheaform group with narrow elongated strands of basaloid cells in a dense fibrous stroma; and 2) a complex morpheaform group with pure morpheaform regions as well as regions with other histological patterns (nodular, etc.). Analysis by sex and body location revealed a female predominance in the pure morpheaform group. Lesions were found primarily on the mid-face in women with pure MBCCs. Using a monoclonal antibody which identifies eccrine duct in routinely fixed tissues, we could not identify eccrine ductal differentiation in MBCCs.
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Affiliation(s)
- T Richman
- Department of Dermatology, University of Miami School of Medicine, Florida
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