Section 17. Infectious Diseases >
Part 7. Viral Infections >
Chapter 317. Molluscum ContagiosumMagdalene A. Dohil and Lawrence F. Eichenfield
Topics Discussed: infectious diseases; molluscipoxvirus; molluscum contagiosum.
Excerpt:"Molluscum contagiosum is a cutaneous
viral infection caused by the poxvirus Molluscipoxvirus,
an approximately 300-nm, double-stranded DNA, brick-shaped virus.
Humans are the only known source of the virus, which is spread by
direct contact, including sexual contact, autoinoculation, or contaminated
fomites. Molluscum can be seen at any age, but are most common in
children younger than 8 years. Outbreaks have been noted among wrestlers
and in pools and water parks. Patients with atopic dermatitis and
immunosuppressed individuals, including persons with HIV infection,
tend to have more intense and widespread eruptions, but most children
presenting with molluscum contagiosum are otherwise healthy and
immunocompetent.1,2Molluscum contagiosum is usually asymptomatic, although an eczematous,
red, scaling patch may surround lesions in about 10% of patients,
and is termed molluscum dermatitis. Molluscum are
usually diagnosed clinically, based on morphology and distribution.
Flat-topped, discrete, dome-shaped, flesh-colored lesions are usually
1 to 5 mm in diameter. Central white cores or umbilication are seen
in active lesions (Fig. 367-5). Molluscum
lesions commonly occur on the trunk, face, and extremities, but
may be generalized.2 Groups of lesions often occur
in body folds and intertriginous areas, secondary to skin-to-skin
autoinoculation. Small, atypical, and giant lesions may be mistaken
for verrucae, keratosis pilaris, milia, bacterial pustules, or cutaneous..."
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