1
|
Suman S, Kumar A. Eyelid Molluscum Contagiosum Presenting as a Giant Nodule With Chronic Refractory Conjunctivitis. Cureus 2024; 16:e57018. [PMID: 38681368 PMCID: PMC11046376 DOI: 10.7759/cureus.57018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
Molluscum contagiosum is a benign cutaneous viral infection caused by a poxvirus, commonly seen in children and adolescents. It typically produces benign, self-limiting eruptions on the skin and mucous membranes, usually on the face, trunks, limbs, and genital areas. The eyelid is the most common site of ocular lesions, less commonly conjunctiva.Eyelid Lesions are typically small papules (two to six mm) with central depressions, or maybe non-umbilicated. Patients with immunodeficiency may have an atypical giant lesion or widely disseminated lesions. We present a case of eyelid molluscum contagiosum presenting with an unusually large nodule with two depressions associated with chronic follicular conjunctivitis in a three-year-old otherwise healthy child. Eyelid lesions were removed surgically. The conjunctival follicular reaction was completely resolved after one month of surgical excision. A histopathological examination confirmed the diagnosis.
Collapse
Affiliation(s)
- Suwarna Suman
- Ophthalmology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Arushi Kumar
- Ear, Nose and Throat, Nalanda Medical College and Hospital, Patna, IND
| |
Collapse
|
2
|
Kowanz DH, Rokohl AC, Heindl LM. [Viral Conjunctivitis: Findings, Therapy, and Prophylaxis]. Klin Monbl Augenheilkd 2023; 240:1317-1331. [PMID: 37586401 DOI: 10.1055/a-2129-1255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Viral conjunctivitis is one of the most common acute eye diseases. The fall and winter months are known to be the main season for viral infections which is also reflected in the ophthalmological outpatient clinics. Viral conjunctivitis is often accompanied by symptoms of the upper and lower respiratory tract, fever, chills, arthralgia or skin lesions. The spectrum of pathogens comprises DNA viruses such as Adeno-, Herpes simplex and Molluscum contagiosum as well as RNA viruses. Symptoms caused by pandemic pathogens such as SARS-CoV-2 and mpox viruses can also cause ocular manifestation. Viral conjunctivitis is often self-limiting leaving no residual symptoms, however an ophthalmologist should be consulted if there are inflammatory symptoms of the anterior eye accompanied by visual disturbance. It is particularly important to recognize the affection of corneal or even intraocular structures early to initiate an adequate and effective therapy. Affection of the cornea, vitreus or retina can result in temporary or permanent impairment of the field of vision and visual acuity. The diagnosis is usually made without further tests on the basis of the typical clinical presentation. Rapid tests or PCR diagnostics are also available for confirmation. In most patients the treatment is symptomatically with artificial tears and antibiotic eye drops in cases accompanied by secondary bacterial infections, not prophylactically. If the cornea or other ocular structures are affected by certain viruses, local as well as systemic virostatic therapy is initiated. The most important prophylactic measure is meticulous and consistent hygiene.
Collapse
|
3
|
Bhatia N, Hebert AA, Del Rosso JQ. Comprehensive Management of Molluscum Contagiosum: Assessment of Clinical Associations, Comorbidities, and Management Principles. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2023; 16:S12-S17. [PMID: 37636015 PMCID: PMC10453397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Despite its high global prevalence, molluscum contagiosum (MC) is not well understood outside of dermatology. Due to the potential self-limiting nature of MC, a common clinical approach in management is to wait for the papules to resolve spontaneously over several weeks to months, without medical intervention. However, this "watch and wait" approach increases risk of spreading the virus to others, extending the duration of the infection, and emergence of several psychosocial issues (e.g., anxiety, embarrassment, isolation). Molluscum contagiosum can be particularly challenging to treat in immunocompromised patients (e.g., human immunodeficiency virus [HIV], organ transplant recipients). This article reviews diagnostic characteristics and treatment options for MC, as well as associated risk factors and comorbidities. Treatment of immunocompromised individuals, in whom the risks of diffuse MC with persistence and spread are relatively high, is emphasized. The authors highlight the importance of actively treating the MC papules, as opposed to letting the virus "run its course" with no active intervention, with the goals of reducing the risk of spreading infection to others, shortening the duration of infection, and decreasing adverse psychosocial sequelae commonly associated with MC.
Collapse
Affiliation(s)
- Neal Bhatia
- Dr. Bhatia is with Therapeutics Clinical Research in San Diego, California
| | - Adelaide A Hebert
- Dr. Hebert is with UTHealth McGovern Medical School in Houston, Texas
| | - James Q Del Rosso
- Dr. Del Rosso is with JDR Dermatology Research and Thomas Dermatology in Las Vegas, Nevada, and Clinical Research at Advanced Dermatology and Cosmetic Surgery in Maitland, Florida
| |
Collapse
|
4
|
Rayati Damavandi A, Semnani F, Hassanpour K. A Review of Monkeypox Ocular Manifestations and Complications: Insights for the 2022 Outbreak. Ophthalmol Ther 2023; 12:55-69. [PMID: 36512187 PMCID: PMC9834445 DOI: 10.1007/s40123-022-00626-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
Monkeypox (MPVX) infection has been associated with multiorgan presentations. Thus, monkeypox infection's early and late complications are of particular concern, prompting health systems to decipher threatening sequels and their possible countermeasures. The current article will review the clinical signs and symptoms of the present and former outbreaks, differential diagnoses, workup and treatment of the ocular manifestations of MPXV infection in detail. One of the uncommon yet considerable MPXV complications is ocular involvement. These injuries are classified as (1) more frequent and benign lesions and (2) less common and vision-threatening sequels. Conjunctivitis, blepharitis and photophobia are the most uncomplicated reported presentations. Moreover, MPXV can manifest as eye redness, frontal headache, orbital and peri-ocular rashes, lacrimation and ocular discharge, subconjunctival nodules and, less frequently, as keratitis, corneal ulceration, opacification, perforation and blindness. The ocular manifestations have been less frequent and arguably less severe within the current outbreak. Despite the possibility of underestimation, the emerging evidence from observational investigations documented rates of around 1% for ocular involvement in the current outbreak compared to a 9-23% incidence in previous outbreaks in the endemic countries. The history of smallpox immunization is a protective factor against these complications. Despite a lack of definite and established treatment, simple therapies like regular lubrication and prophylactic use of topical antibiotics may be considered for MPXV ocular complications. Timely administration of specific antivirals may also be effective in severe cases. Monkeypox usually has mild to moderate severity and a self-limited course. However, timely recognition and proper management of the disease could reduce the risk of permanent ocular sequelae and disease morbidity.
Collapse
Affiliation(s)
- Amirmasoud Rayati Damavandi
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farbod Semnani
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiana Hassanpour
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Paidarfard St, Bostaan 9th St, Pasdaran, Tehran, 16666 Iran
| |
Collapse
|
5
|
Andaluz-Scher LE, Nudelman NT, Storey NA, Barry GP. Eyelid molluscum contagiosum lesion in a pediatric patient treated with topical nail polish. J AAPOS 2023; 27:60-62. [PMID: 36521819 DOI: 10.1016/j.jaapos.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Abstract
Molluscum contagiosum causes umbilicated periocular lesions, which commonly affect children. Topical clear nail polish for treatment of molluscum has been reported anecdotally, but there are few reports in the medical literature. We report the case of an eyelid molluscum lesion in an 8-year-old girl that resolved with 4 topical applications of nail polish over 6 weeks.
Collapse
Affiliation(s)
| | | | | | - Gerard P Barry
- Department of Ophthalmology, Albany Medical College, Albany, New York
| |
Collapse
|
6
|
Vorwerk P, Dießel L, Heichel J. [Treatment-resistant chronic conjunctivitis]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2022; 74:997-999. [PMID: 37707555 PMCID: PMC10661817 DOI: 10.1007/s00105-023-05225-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Paul Vorwerk
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
| | - Linda Dießel
- Institut für Pathologie, Universitätsklinikum Halle, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Jens Heichel
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| |
Collapse
|
7
|
Al Akrash LS, Al Semari MA, Al Harithy R. Ocular manifestations of dermatological diseases part II: genodermatoses. Int J Dermatol 2020; 60:133-140. [PMID: 32946638 DOI: 10.1111/ijd.15173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 11/27/2022]
Abstract
Skin and eyes share a common embryological origin from the embryonic surface ectoderm. Ocular manifestations in dermatological diseases are common and have diagnostic value. At present, there are a limited number of comprehensive reviews emphasizing the ocular manifestations of dermatological diseases. More than 40 published articles about ocular findings in dermatology were reviewed. The search included Pubmed, Google Scholar, and Cochrane databases from 2014 to 2019. This review was divided into three parts including: I. infectious and inflammatory disorders; II. genodermatoses; III. connective tissue, autoimmune, neoplasms, and drug-related disorders. We excluded metabolic, endocrine, and nutrition-related dermatological diseases. In this part, we summarized the most common and important ocular findings in dermatology-related genetic disorders with appropriate referral recommendations to ophthalmology.
Collapse
Affiliation(s)
- Lamia S Al Akrash
- Dermatology Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Ruaa Al Harithy
- Dermatology Department, Security Forces Hospital, Riyadh, Saudi Arabia
| |
Collapse
|
8
|
Azari AA, Arabi A. Conjunctivitis: A Systematic Review. J Ophthalmic Vis Res 2020; 15:372-395. [PMID: 32864068 PMCID: PMC7431717 DOI: 10.18502/jovr.v15i3.7456] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/25/2020] [Indexed: 01/10/2023] Open
Abstract
Conjunctivitis is a commonly encountered condition in ophthalmology clinics throughout the world. In the management of suspected cases of conjunctivitis, alarming signs for more serious intraocular conditions, such as severe pain, decreased vision, and painful pupillary reaction, must be considered. Additionally, a thorough medical and ophthalmic history should be obtained and a thorough physical examination should be done in patients with atypical findings and chronic course. Concurrent physical exam findings with relevant history may reveal the presence of a systemic condition with involvement of the conjunctiva. Viral conjunctivitis remains to be the most common overall cause of conjunctivitis. Bacterial conjunctivitis is encountered less frequently and it is the second most common cause of infectious conjunctivitis. Allergic conjunctivitis is encountered in nearly half of the population and the findings include itching, mucoid discharge, chemosis, and eyelid edema. Long-term usage of eye drops with preservatives in a patient with conjunctival irritation and discharge points to the toxic conjunctivitis as the underlying etiology. Effective management of conjunctivitis includes timely diagnosis, appropriate differentiation of the various etiologies, and appropriate treatment.
Collapse
Affiliation(s)
- Amir A Azari
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Arabi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Al Akrash LS, Al Semari MA, Al Harithy R. Ocular manifestations of dermatological diseases part I: infectious and inflammatory disorders. Int J Dermatol 2020; 60:5-11. [PMID: 33232519 DOI: 10.1111/ijd.15101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 06/11/2020] [Accepted: 07/13/2020] [Indexed: 12/21/2022]
Abstract
Skin and eyes share a common embryological origin from the embryonic surface ectoderm. Ocular manifestations are one of the most important and common associations of dermatological diseases. Currently, there are few comprehensive reviews of the ocular manifestations of dermatological diseases. We have reviewed more than 40 published articles related to the ocular manifestations of the most important dermatological diseases. The search included Pubmed, Google Scholar, and Cochrane databases from 2014 to 2019. This review was divided into three parts including infections, inflammatory, genetics, connective tissue, autoimmune, neoplasms, and drug-related disorders. We excluded metabolic, endocrine, and nutrition-related dermatological diseases. The relationship of ocular manifestations and dermatological diseases is important to recognize for appropriate management since many dermatological diseases can manifest initially with ocular findings. In this part, we summarized the most common and significant ocular findings in infectious and inflammatory dermatological disorders with appropriate referral recommendations to ophthalmology.
Collapse
Affiliation(s)
- Lamia S Al Akrash
- Dermatology Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Ruaa Al Harithy
- Dermatology Department, Security Forces Hospital, Riyadh, Saudi Arabia
| |
Collapse
|
10
|
Sinha P, Sivasankari M, Radhakrishnan S. Isolated scalp lesions of molluscum contagiosum—Report of three cases. Indian Dermatol Online J 2020; 11:648-650. [PMID: 32832466 PMCID: PMC7413453 DOI: 10.4103/idoj.idoj_454_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/17/2020] [Accepted: 02/26/2020] [Indexed: 12/01/2022] Open
|
11
|
Moustaine MO, Allali B, El Maaloum L, El Kettani A, Zaghloul K. [Eyelid molluscum contagiosum: a case report]. Pan Afr Med J 2019; 32:177. [PMID: 31312291 PMCID: PMC6620081 DOI: 10.11604/pamj.2019.32.177.18418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/10/2019] [Indexed: 11/25/2022] Open
Abstract
Les Molluscums contagiosum (MC) sont des lésions cutanées bénignes causées par Molluscipoxvirus, ils affectent principalement les enfants et les adultes jeunes et intéressent surtout la peau et rarement les muqueuses. Le diagnostic clinique est facile, confirmé par l'analyse histologique de la lésion, cependant il n'existe pas de consensus concernant la prise en charge thérapeutique. La localisation palpébrale de MC est rare, elle pose un problème d'ordre diagnostic différentiel surtout lorsqu'elle est isolée et un problème thérapeutique vu la proximité du globe oculaire. Nous rapportons le cas d'une fille de 7 ans ayant présenté une lésion palpébrale isolée dont l'exérèse avec étude anatomopathologique a révélé un MC. A la lumière de cette observation nous décrivons les particularités cliniques, thérapeutiques, et évolutives de cette localisation rare du molluscum contagiosum.
Collapse
Affiliation(s)
- Moulay Omar Moustaine
- Service d'Ophtalmologie Pédiatrique, Hôpital 20 août, Centre Hospitalier Universitaire Ibn Rochd Casablanca, Casablanca, Maroc.,Service d'Ophtalmologie, Centre Hospitalier Provincial la Marche Verte, Boulmane-Missour, Maroc
| | - Bouchra Allali
- Service d'Ophtalmologie Pédiatrique, Hôpital 20 août, Centre Hospitalier Universitaire Ibn Rochd Casablanca, Casablanca, Maroc
| | - Loubna El Maaloum
- Service d'Ophtalmologie Pédiatrique, Hôpital 20 août, Centre Hospitalier Universitaire Ibn Rochd Casablanca, Casablanca, Maroc
| | - Asmaa El Kettani
- Service d'Ophtalmologie Pédiatrique, Hôpital 20 août, Centre Hospitalier Universitaire Ibn Rochd Casablanca, Casablanca, Maroc
| | - Khalid Zaghloul
- Service d'Ophtalmologie Pédiatrique, Hôpital 20 août, Centre Hospitalier Universitaire Ibn Rochd Casablanca, Casablanca, Maroc
| |
Collapse
|
12
|
Meza-Romero R, Navarrete-Dechent C, Downey C. Molluscum contagiosum: an update and review of new perspectives in etiology, diagnosis, and treatment. Clin Cosmet Investig Dermatol 2019; 12:373-381. [PMID: 31239742 PMCID: PMC6553952 DOI: 10.2147/ccid.s187224] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 05/07/2019] [Indexed: 12/20/2022]
Abstract
Molluscum contagiosum (MC) is a self-limited infectious dermatosis, frequent in pediatric population, sexually active adults, and immunocompromised individuals. It is caused by molluscum contagiosum virus (MCV) which is a virus of the Poxviridae family. MCV is transmitted mainly by direct contact with infected skin, which can be sexual, non-sexual, or autoinoculation. Clinically, MC presents as firm rounded papules, pink or skin-colored, with a shiny and umbilicated surface. The duration of the lesions is variable, but in most cases, they are self-limited in a period of 6-9 months. The skin lesions may vary in size, shape, and location, which is more frequent in immunosuppressed patients, and could present complications such as eczema and bacterial superinfection. The diagnosis is based on clinical findings. A useful clinical tool is dermoscopy. If the diagnostic doubt persists, confocal microscopy or skin biopsy could be performed. The need for active treatment for MC is controversial; however, there is a consensus that it should be indicated in cases of extensive disease, associated with complications or aesthetic complaints. There are several treatment modalities which include mechanical, chemical, immunomodulatory, and antivirals. The objective of this article is to review the current evidence in etiology, clinical manifestations, diagnosis, and management alternatives of MC.
Collapse
Affiliation(s)
- Rodrigo Meza-Romero
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristián Navarrete-Dechent
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Camila Downey
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
13
|
Mutalik SD, Rasal YD. Successful Use of Oral Acyclovir in Ophthalmic Molluscum Contagiosum. Indian Dermatol Online J 2019; 10:456-459. [PMID: 31334070 PMCID: PMC6615381 DOI: 10.4103/idoj.idoj_390_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Molluscum contagiosum is a common tropical contagious viral infection, involving the skin and the mucous membranes. Ophthalmic molluscum contagiosum is a relatively uncommon condition presenting as secondary follicular conjunctivitis or kerato-conjunctivitis and may present with or without obvious dermal skin lesions. Often, unsuspected and misdiagnosed by eye care providers or observed as a concomitant feature by a skin care provider, unilateral conjunctivitis due to molluscum contagiosum remains easily treatable. Clearance of the primary skin lesion leads to rapid and complete resolution of ophthalmic signs. Two cases of ophthalmic molluscum contagiosum treated successfully with oral antiviral drug acyclovir are presented herewith as anecdotal therapeutic evidence.
Collapse
Affiliation(s)
- Sharad D Mutalik
- Department of Dermatotherapy and Cosmetology, Maharashtra Medical Foundation's Joshi Hospital, Pune, Maharashtra, India
| | - Yashashree D Rasal
- Department of Dermatotherapy and Cosmetology, Maharashtra Medical Foundation's Joshi Hospital, Pune, Maharashtra, India
| |
Collapse
|