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HIV is a type of virus that attack the immune system, causing it unable to function normally and putting the person in a condition called immunocompromised and is vulnerable to lots of infection. People living with HIV are prone to complications if there is persisting infection and inflammation. One of the inflammation markers is theneutrophil-lymphocyte ratio(NLR). Complication on the skin is one of the frequently happened. One of it is Molluscum contagiosum. Molluscum contagiosum caused by virus infection which target the epidermal layer of the skin that result in formation of round, umbilicated, painless papule or nodule. In this case report, we present a male, 49 years old which has complained of persistent fatigue and diarrhea. There is multiple rounds, skin-colored, painless papules on his face and neck since 6 month ago which keep increasing. Laboratory result show decrease in hemoglobin and high neutrophil lymphocyte ratio. In HIV, the NLR value has a significant negative correlation with the CD4 amount. The existence of molluscum contagiosum in an adult with unknown HIV status need to be considered as a possibility of an immunocompromised especially if accompanied with other conditions. In the patient with HIV, with the existence of Molluscum contagiosum, the possibility of decreasing CD4 and increasing viral load need to be suspected. The patient抯 obedience in consuming ARV also needs a careful attention.
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Introduction: Molluscum contagiosum (MC) is a common skin and mucosal disease caused by MC virus of pox virus family. Lesion manifests both in immunocompromised and immunocompetent individuals. Case Presentation: The case is of MC in 40 year old female patient on right cheek since three months. The growth was asymp- tomatic and nodular. HIV status of the patient was negative with no other medical history. The excised specimen on histological examinations showed lobules of proliferating epithelium. Cells in the center showed basophilic viral inclusion bodies called “Henderson-Paterson bodies” based on these features lesion was diagnosed as MC. Management and prognosis: Lesion was treated surgically. Follow up of six months showed no recurrence or any new lesions. Conclusion: MC is commonly manifested in immunocompromised patients but can rarely be present in immunocompetent patient, so should be considered in the list of differential diagnosis.
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Resumen El molusco contagioso es una infección viral cutánea, usualmente benigna y autolimitada, causada por un virus del género Molluscipoxvirus. Es más frecuente en niños, adultos jóvenes sexualmente activos e inmunosuprimidos. La lesión clínica característica es una pápula umbilicada eucrómica o de tono perlado, que se disemina rápidamente y puede afectar cualquier superficie muco-cutánea, aunque la localización en los párpados es atípica. Se presentan dos casos de pacientes jóvenes inmunosuprimidos, con moluscos contagiosos palpebrales, en quienes el diagnóstico clínico inicial fue incorrecto. Se enfatiza la importancia de diagnosti car oportunamente las lesiones papulares que afectan la piel del párpado ya que la presencia de molusco contagioso en esta zona se considera una manifestación cutánea de inmunosupresión.
Abstract Molluscum contagiosum is a cutaneous viral infection, usually benign and self-limited, caused by the molluscum contagiosum virus, of the genus Molluscipoxvirus. It is more common in pediatric population, sexually active young people and immunosuppressed patients. Clinical presentation is characterized by umbilicated white to flesh-colored or pearly papules, which rapidly spread and can affect any muco-cutaneous membrane. Although the eyelid presentation is atypical, we herein present two young, immunosuppressed patients, with diagnosis of palpebral molluscum contagiosum, in which the initial clinical diagnosis was wrong. We emphasize the importance in making a timely diagnosis of papular lesions localized on the eyelids and the correlation of these lesions as a cutaneous manifestation of immunosuppression.
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Abstract Atopic dermatitis predisposes to skin infections, and on the other hand, some therapies used for atopic dermatitis may worsen viral infections whose lesions may be more diffuse and resistant to treatment. The authors present a patient with severe atopic dermatitis and disseminated molluscum contagiosum infection. The molluscum contagiosum did not clear with topical treatment, and it worsened her atopic dermatitis even more, so the authors started treatment with dupilumab. After two months, the patient's dermatitis went into clinical remission and there was resolution of the infection with no recurrence at the 12-month follow-up. Dupilumab is nowadays a promising treatment for severe atopic dermatitis. To our knowledge, only four reports of molluscum contagiosum during dupilumab therapy have been reported in the literature, with contrasting effects. According to the authors' experience, treatment with dupilumab appears to be a safe alternative for patients with severe atopic dermatitis who are also infected with molluscum contagiosum, as opposed to other treatments such as systemic corticosteroids or cyclosporine.
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Introduction: Molluscum contagiosum is a dermatosis caused by a DNA virus of the family Poxvirus and genus Molluscipoxvirus, affecting mainly children, sexually active adults, atopic individuals and immunocompromised patients, especially those with human immunodeficiency virus (HIV) infection. Objective: To describe our experience in caring for patients living with HIV who presented with extensive and severe Molluscum contagiosum, and to conduct a literature review on the subject as well. Methods: An electronic search was carried out in the MEDLINE/PubMed and SciELO databases and in the books: ATLAIDS and AZULAY limited to the period of January 2017 to June 2021. Results: Four clinical cases are reported in people living with HIV with extensive lesions normally not found in immunocompetent patients. The treatment performed in the cases reported in this article was the punctual application of 90% trichloroacetic acid (TCA) to each lesion, with complete remission of the clinical presentation in two patients over a period of three and six months. The other two patients did not receive treatment for molluscum contagiosum as they died because of pulmonary complications. Conclusion: Infection with Molluscum contagiosum in people living with HIV has disseminated forms with large-volume lesions, with substantial stigmatizing aesthetic impairment, and treatment with 100% TCA is quite effective.
Introdução: Molusco contagioso é uma dermatose causada por um vírus de DNA da família poxvírus e do gênero Molluscipoxvirus. Afeta principalmente crianças, adultos sexualmente ativos, indivíduos atópicos e pacientes imunodeprimidos, especialmente aqueles com infecção pelo vírus da imunodeficiência humana (HIV). Objetivo: Descrever a experiência no atendimento de pacientes vivendo com HIV que apresentaram quadro de molusco contagioso extenso e grave, além de realizar uma revisão da literatura sobre o tema. Métodos: Foi realizada uma pesquisa eletrônica nas bases de dados MEDLINE/PubMed e SciELO e nos livros ATLAIDS e AZULAY, limitada ao período de janeiro de 2017 a junho de 2021. Resultados: São relatados quatro casos clínicos em pessoas que vivem com HIV com lesões extensas normalmente não encontradas em pacientes imunocompetentes O tratamento realizado nos casos relatados nesse artigo foi a aplicação pontual de ácido tricloroacético (ATC) 100% em cada lesão, com a remissão completa do quadro clínico em dois pacientes em um período de tempo entre três e seis meses. Os outros dois pacientes não receberam tratamento para o vírus do molusco contagioso pois evoluíram para óbito em razão de complicações pulmonares. Conclusão: A infecção pelo molusco contagioso em pessoas vivendo com HIV apresenta formas disseminadas com lesões de grande volume, com comprometimento estético estigmatizante importante, e o tratamento com ATC 90% é bastante eficaz.
Subject(s)
Humans , Acquired Immunodeficiency Syndrome , HIV , Molluscipoxvirus , Skin Diseases , Wounds and Injuries , Immunocompromised Host , Molluscum ContagiosumABSTRACT
A tatuagem é uma prática antiga e muito popular atualmente. Os pigmentos utilizados mudaram com o tempo, mas continuam apresentando composições variadas e pouco regulamentadas. Há inúmeros casos descritos de efeitos adversos pós-tatuagem, em sua maioria infecciosos, e reações de hipersensibilidade. Relatamos o caso de uma mulher de 64 anos, hígida, com pápulas nas sobrancelhas um mês após realizar micropigmentação. A biópsia excisional fez o diagnóstico de molusco contagioso, e o tratamento foi realizado com curetagem das lesões. Na literatura, existem poucos relatos de disseminação de molusco contagioso causada por tatuagem.
Tattooing is an ancient practice and very popular nowadays. The pigments used have changed over time but still present varied and poorly regulated compositions. There are many described cases of adverse effects after tattooing, mainly infectious and hypersensitivity reactions. We report the case of a 64-yearold woman, healthy, with papules on her eyebrows one month after performing micropigmentation. The excisional biopsy diagnosed molluscum contagiosum, and the lesions were curetted. There are few reports in the literature of the spread of molluscum contagiosum caused by tattooing
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La infección por molusco contagioso (MC) en adultos se asocia frecuentemente a transmisión sexual y/o inmunodepresión, por ejemplo, por VIH. En este grupo, la manifestación clínica suele ser atípica. A continuación, se presenta el caso de un paciente con diagnóstico de VIH, bajo recuento de CD4 y carga viral elevada que consulta por múltiples MC en genitales, tronco, cara y ojos además de conjuntivitis en ojo derecho. Se mantuvo terapia antirretroviral (TARV) y se indicó tratamiento para conjuntivitis. La infección por MC en pacientes con VIH se asocia a etapas SIDA con un aumento de los casos a menor recuento de linfocitos CD4, generalmente menor a 200 cel/mL. La pobre respuesta inmune celular de estos pacientes explica su comportamiento clínico atípico. Este grupo presenta una mayor mortalidad que el de pacientes seropositivos sin MC, lo que se explica por la mayor inmunosupresión asociada. El diagnóstico es clínico, aunque podría verse entorpecido cuando hay compromiso ocular por la presencia de lesiones atípicas que hacen necesario considerar diversos diagnósticos diferenciales. El tratamiento es controversial y tiende a existir una baja respuesta y recidiva frente a terapias convencionales en pacientes con VIH cuando la inmunosupresión es marcada por el recuento CD4 muy bajo. La TARV pareciera ser la mejor alternativa para su tratamiento, sin embargo, es importante considerar posibles complicaciones asociadas, como la instauración de síndrome de restauración inmunológica una vez iniciada. Esto podría traducirse en lesiones oculares graves cuando existe compromiso en este órgano
Molluscum contagiosum (MC) infection in adults is frequently associated with sexual transmission and / or immunosuppression, for example by HIV. In this group, the clinical manifestation is usually atypical. Herein we present the case of a patient with a diagnosis of HIV, a low CD4 count and a high viral load who consulted for multiple MC in the genitals, trunk, face and eyes, as well as conjunctivitis in the right eye. Antiretrovitral therapy (ART) was maintained and treatment for conjunctivitis was indicated. MC infection in HIV patients is associated with AIDS stages with an increase in cases with a lower CD4 lymphocyte count, generally less than 200 cells / mL. The poor cellular immune response of these patients explains their atypical clinical behavior. This group presents a higher mortality than that of seropositive patients without MC, which is explained by the greater associated immunosuppression. The diagnosis is clinical, although it could be hampered when there is ocular compromise due to the presence of atypical lesions that make it necessary to consider various differential diagnoses. Treatment is controversial and there tends to be a poor response and relapse to conventional therapies in patients with HIV when immunosuppression is marked by a very low CD4 count. ART seems to be the best alternative for its. However, it is important to consider possible associated complications such as the onset of immune restoration syndrome once it has been started. This could translate into serious eye injuries when this organ is compromised
Subject(s)
Humans , Male , Adult , HIV Infections/complications , Conjunctivitis, Viral/etiology , Molluscum Contagiosum/etiology , Conjunctivitis, Viral/diagnosis , Conjunctivitis, Viral/drug therapy , Molluscum Contagiosum/diagnosis , Molluscum Contagiosum/drug therapyABSTRACT
Objective To evaluate the efficacy and safety of 585 nm pulsed dye laser for the treatment of molluscum contagiosum in children.Methods Between September 2016 and February 2017,50 children with confirmed molluscum contagiosum were enrolled from Maternal and Child Health Care Hospital of Zibo.These children were treated with 585 nm pulsed dye laser at energy of 6.0-9.0 J/cm2,pulse width of 0.5 ms and spot size of 5 mm.If a patient was not cured after 1 session of the laser treatment,another session of the laser treatment would be performed 1 month after the first treatment.If the proportion of regressed skin lesions was less than 30％ after more than 2 consecutive sessions of the laser treatment,the treatment would be stopped.After the treatment,the patients were followed up for 6 months.During the follow-up,clinical efficacy was evaluated according to regression of skin lesions,and adverse reactions and recurrence were recorded.Results All the patients completed the trial.After the treatment,44 (88％)patients were cured,and the response rate was 94％ (47/50).After 1 session of the treatment,32 (64％)patients were cured.After the laser treatment,purpura occurred instantly,hyperpigmentation and hypopigmentation occurred in a short-term period,and no obvious long-term adverse reactions were observed.During the follow-up,no new wart was found at the site of regressed warts after the treatment.Conclusion The 585 nm pulsed dye laser shows good efficacy,safety and tolerance in the treatment of molluscum contagiosum.
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Background: Sexually transmitted infections (STIs) constitute a major health problem in the developing countries and prevalence of STIs varies from region to region in our country. Aim: To study the pattern and prevalence of sexually transmitted infections and HIV seropositivity among patients presenting in a tertiary care center. Materials and methods: A retrospective data was collected in the department of Dermatology at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIHMS), Shri Mahant Indiresh Hospital (SMIH), a tertiary care center in Dehradun, Uttarakhand, India, from January 2011 to December 2018. A total of 525 patients were analyzed in this study. Results: A total of 525 patients were enrolled in our study. STIs were more common in men, with male (365): female (160) ratio of 2.2:1. Maximum numbers of patients were in the age group of 25 to 34 years. Unskilled workers (22.28%) and housewives (20.00%) constituted major proportion. Majority of the cases presented with warts (38.09%) followed by molluscum contagiosum (20.95%) and herpes genitalis (19.61%). But herpes genitalis (27.39%) was found to be the most common STD seen among males and warts (68.75%) among the females. HIV seropositivity was seen among 20 (3.80%) patients and was most commonly associated with herpes genitalis infection (60.00%). Gunjan Gupta, Jitendra Singh Bist, Rahul Sudan, Kewal Krishan, Neeti Kumari. Clinicoepidemiological profile of sexually transmitted disease (STD) patients presenting in a tertiary care center. IAIM, 2019; 6(2): 7-12. Page 8 Conclusion: Increased prevalence of viral STDs like herpes genitalis, genital warts and mollascum contagiosum was seen in our study. Widespread use of antibacterial lead to falling trend of bacterial STDs.
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El molusco contagioso (MC) es una infección viral frecuente, generalmente fácil de diagnosticar gracias a sus manifestaciones clínicas características. Sin embargo, las presentaciones clínicas atípicas pueden suponer un desafío diagnóstico. La dermatoscopia ha ayudado en estos casos complejos, al mostrar un patrón dermatoscópico característico compuesto por un poro central o umbilicación junto con estructuras amorfas polilobulares de color blanco a amarillo, rodeadas de vasos lineales o ramificados ('vasos en corona"). Sin embargo, se pueden encontrar patrones dermatoscópicos adicionales. Presentamos dos casos de MC donde se observaron rosetas en la dermatoscopia.
Molluscum contagiosum (MC), a frequent viral infection, is generally easy to diagnose because of its characteristic clinical features. However, atypical presentations can be a diagnostic challenge for clinicians. Dermoscopy has helped in this cases by showing a characteristic dermoscopic pattern composed of a central pore or umbilication in conjunction with polylobular white to yellow amorphous structures, surrounded by linear or branched vessels ('red crown"). However, additional dermoscopic patterns can be found. Herein we present two MC cases where rosettes were seen on dermoscopy
Subject(s)
Humans , Female , Child , Adolescent , Adult , Skin/pathology , Dermoscopy/methods , Molluscum Contagiosum/diagnosisABSTRACT
Resumen ANTECEDENTES La infección por el virus de inmunodeficiencia humana (VIH) incrementa la prevalencia de prolongación del intervalo QT corregido (QTc), lo que es un factor independiente de eventos de enfermedad cardiovascular en esta población. En la bibliografía mundial se asocia este cambio con la administración de los antirretrovirales inhibidores de proteasa y efavirenz. Sin embargo, no se conocen datos de estos cambios en la población mexicana. MATERIAL Y MÉTODO Estudio prospectivo observacional en el que se seleccionaron expedientes de marzo de 2015 a mayo de 2016 de la consulta externa del Instituto Nacional de Enfermedades Respiratorias (INER); se dividieron en dos grupos: sin tratamiento, por reciente diagnóstico, y con tratamiento antirretroviral. Se registraron datos clínicos, tratamiento farmacológico, electrocardiograma y química sanguínea. RESULTADOS No se encontraron diferencias entre ambos grupos respecto a edad ni electrólitos séricos. Tampoco se encontró relación entre la prolongación del QTc con efavirenz o los inhibidores de proteasa. Raltegravir disminuyó la duración del QTc (p = 0.001) mientras que la coinfección por molusco contagioso se asoció con prolongación del QTc (p = 0.02). CONCLUSIÓN En nuestro estudio no logramos demostrar en población mexicana relación de la prolongación del QTc con los antirretrovirales de primera ni segunda línea. Se requieren más estudios para determinar la importancia clínica del efecto de raltegravir y molusco contagioso en el QTc.
Abstract BACKGROUND Human immunodeficiency virus (HIV) infection increases the prevalence of QTc prolongation (QTc), which is an independent factor of cardiovascular disease events in this population. In the world literature this change is associated with the use of the protease inhibitors and efavirenz antiretrovirals. However, no data are available on these changes in the Mexican population. MATERIAL AND METHOD A prospective observational study was done selecting records from March 2015 to May 2016 of the external consultation of the National Institute of Respiratory Diseases (INER), Mexico City; they were divided into two groups, those without treatment, because recent diagnosis, and with antiretroviral treatment. We recorded clinical data, pharmacological treatment, electrocardiogram and blood chemistry. RESULTS We found no differences between the two groups regarding age or serum electrolytes. We found no association between QTc prolongation and efavirenz or protease inhibitors. Raltegravir decreased QTc duration (p = 0.001) while molluscum contagiosum coinfection was associated with QTc prolongation (p = 0.02). CONCLUSION In our study, we failed to demonstrate in Mexican population association of QTc prolongation with first- and second-line antiretrovirals. More studies are needed to determine the clinical significance of the effect of raltegravir and molluscum contagiosum on QTc.
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Wells' syndrome or eosinophilic cellulitis is usually observed in adults who present with pruritic, erythematous and edematous plaques associated with papules or vesicles. It is a rare inflammatory dermatosis of unknown etiology showing an eosinophil-mediated immune response. Classical histopathological features observed in patients are eosinophil-predominant inflammatory infiltration and marked dermal edema, along with ‘flame figures’. An 11-year-old boy presented with edematous plaques surmounted by vesicles on his abdomen and lower extremities. A month prior to presentation, these skin lesions occurred on other parts of his abdomen; however, they resolved spontaneously within a week. Skin biopsies from the recurrent lesions showed features consistent with Wells' syndrome and a few molluscum bodies in the epidermis. Laboratory tests showed peripheral eosinophilia. We concluded that Wells' syndrome in this young patient was caused by preceding molluscum contagiosum infection.
Subject(s)
Adult , Child , Humans , Male , Abdomen , Biopsy , Cellulitis , Edema , Eosinophilia , Eosinophils , Epidermis , Lower Extremity , Molluscum Contagiosum , Skin , Skin DiseasesABSTRACT
No abstract available.
Subject(s)
Humans , Acquired Immunodeficiency Syndrome , HIV , Molluscum ContagiosumABSTRACT
Objetivo: Molusco contagioso é uma infecção cutânea, causada pelo Molluscipox vírus. Diante da inexistência de um tratamento específico, esta pesquisa tem como objetivo verificar, segundo a literatura recente, os melhores métodos de tratamento em crianças imunocompetentes. Métodos: Revisão sistemática de literatura realizada no PubMed, bem como no Lilacs, Scielo, Medline e demais bases de dados abrangidas na Biblioteca Virtual em Saúde (BVS), com publicações de 2010 a 2016. Para evitar viés, foram utilizadas recomendações do PRISMA. Critérios do Oxford Centre for Evidence-Based Medicine e do sistema GRADE foram usados para classificação do nível de evidência dos estudos. Resultados: Curetagem, laser pulsado de contraste, crioterapia, exérese cirúrgica, KOH 2,5%, 5% e 10%, ácido tricloroacétrico, combinação de ácido lático e ácido salicílico, tretinoína 0,05% apresentaram boa proporção de cura, facilidade de realização e tempo de resolução. Os métodos de injeção intralesional do antígeno da Cândida e da vacina MMR, dieta balanceada, óleo de Malaleuca alternifólia e Ingenol Mebutate 0,05% mostraram-se promissores. Entretanto, cantaridina e imiquimod 5% creme não foram recomendados. Conclusão: As evidências obtidas não permitem indicar um método preferencial. A escolha do método de tratamento deve ser individualizada. Recomenda-se realizar mais pesquisas voltadas para cultura do vírus.
Objective: Molluscum contagiosum is a skin infection caused by the Molluscipox virus. Given the absence of a specific treatment, this study aims to verify according to recent literature the best methods for molluscum contagiosum treatment in immunocompetent children. Methods: This study is a systematic review conducted in PubMed, as well as Lilacs, Scielo, Medline and other data bases from the Biblioteca Virtual em Saúde (BVS), including publications from 2010 to 2016. The bias is avoided by using PRISMA recommendations . Criteria of the Oxford Center for Evidence-Based Medicine and the GRADE system were used to rank the level of evidence of the studies. Results: Curettage, pulsed dye laser, cryotherapy, surgical abscission, KOH 2.5%, 5% and 10%, trichloroacetic acid, combination of lactic acid and salicylic acid and 0.05% tretinoin showed good performances regarding cure rate, ease of implementation and resolution time. Moreover, methods such intralesional injection of antigen Candida and the MMR vaccine, balanced diet, Malaleuca oil alternifolia and ingenol Mebutate 0.05% showed relevant results. However, the use of cantharidin and imiquimod 5% cream is not recommended. Conclusion: It is not possible to indicate the most eligible method based on the evidence found. Therefore, treatment should be individualized. Future researches about the virus culture are recommended.
Objetivo: El molusco contagioso es una infección de la piel causada por el virus Molluscipox. Dada la ausencia de un tratamiento específico, la presente investigación tiene como objetivo verificar, de acuerdo con la literatura reciente, los mejores métodos de tratamiento en niños inmunocompetentes. Métodos: Revisión sistemática de la literatura realizada en el Pubmed, así como en Lilacs, Scielo, Medline y otras bases de datos en la Biblioteca Virtual de Salud (BVS), con publicaciones de 2010 a 2016. Para evitar sesgos, se utilizaron las recomendaciones del PRISMA. Se utilizaron los criterios del Centro de Oxford para la Medicina Basada en la Evidencia y el sistema GRADE para clasificar el nivel de evidencia de los estudios. Resultados: Curetaje, láser pulsado de contraste, crioterapia, exéresis quirúrgica, KOH 2,5%, 5% y 10%, ácido tricloroacétrico, la combinación de ácido láctico y ácido salicílico, tretinoína 0,05% exhibieron buena tasa de curación, facilidad de realización y tiempo de resolución. Los métodos de inyección intralesional de antígenos de Cándida y la vacuna triple vírica, dieta equilibrada, aceite de alternifolia Malaleuca y ingenol mebutate 0,05% se muestran prometedores. Sin embargo, no se recomienda las cremas de cantaridina y imiquimod al 5%. Conclusión: Las evidencias obtenidas no han elegido un método preferido. La elección del método de tratamiento debe ser individualizada. Se recomienda la realización de más investigaciones relcionadas con el cultivo del virus.
Subject(s)
Humans , Molluscum Contagiosum/therapy , Treatment Outcome , Skin Diseases, Viral , Virus DiseasesABSTRACT
Introdução: Molusco contagioso é uma dermatovirose causada por um poxvírus. Na literatura há descrição de diferentes abordagens terapêuticas dessa infecção. Objetivo: Avaliar a eficácia do imiquimode para tratamento de molusco contagioso de forma isolada e associada à curetagem. Métodos: Grupo A, 20 pacientes utilizaram imiquimode 5% creme, 3 vezes por semana por 6 semanas e Grupo B, 10 pacientes que utilizaram creme base, 3 vezes por semana por 6 semanas. Após estas 6 semanas, todos os pacientes se submeteram à curetagem. Resultados: Grupo A, na sexta semana diminuição de 31% no número de lesões, com uma efetividade da curetagem de 97,6%; Grupo B na sexta semana um aumento de 4,8% no número de lesões e uma efetividade da curetagem de 81,1%. A média do nível de dor durante a curetagem foi de 1,8 para o Grupo A e 3,0 para o Grupo B. Conclusões: Por aumentar a taxa de eliminação de lesões de molusco contagioso e diminuir a dor quando o processo de curetagem é realizado após uso do imunomodulador, concluímos que a associação de imiquimode 5% em creme com curetagem possa ser uma possibilidade terapêutica.
Introduction: Molluscum contagiosum is a dermatovirosis caused by a poxvirus. In the literature there are descriptions of different therapeutic approaches of this infection. Objective: To evaluate the efficacy of imiquimod isolated and associated with curettage in the treatment of molluscum contagiosum. Methods: Group A: 20 patients used 5% imiquimod cream 3 times a week for 6 weeks. Group B: 10 patients used a creamy base 3 times a week, for 6 weeks. After the initial 6 weeks, all patients underwent curettage. Results: Group A: 31% decrease in the number of lesions in the 6th week, with a curettage effectiveness of 97.6%; Group B: 4.8% increase in the number of lesions in the 6th week, with a curettage effectiveness of 81.1%. The mean value for the pain level during curettage was 1.8 for Group A and 3.0 for Group B. Conclusions: Due to the facts that the rate of cure of contagious molluscum lesions increased and the pain decreased when the curettage procedure was conducted after the use of the immunomodulator, it was possible to conclude that the association of 5% imiquimod cream to the curettage may be a therapeutic possibility.
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Abstract: Milia-like idiopathic calcinosis cutis (MICC) is a very rare dermatological disorder characterized by multiple whitish to skin colored, milia-like papules, mostly found on the hands. MICC can disappear spontaneously by adulthood; therefore, its early recognition is crucial to avoiding unnecessary interventions. Herein, we present a case of MICC in a 6-year-old girl with Down syndrome.
Subject(s)
Female , Child , Skin Diseases/diagnosis , Calcinosis/diagnosis , Down Syndrome/complications , Skin Diseases/pathology , Calcinosis/complications , Calcinosis/pathology , Dermoscopy , Facial Dermatoses/diagnosis , Facial Dermatoses/pathology , Foot Dermatoses/diagnosis , Foot Dermatoses/pathology , Hand Dermatoses/diagnosis , Hand Dermatoses/pathologyABSTRACT
Halo nevi (HN), also known as Sutton's nevi or leukoderma acquisitum centrifugum, are nevomelanocytic nevi surrounded by a rim of depigmentation. A 9-year-old female presented with an asymptomatic solitary flesh-colored 0.75-cm-sized papule surrounded by depigmentation on the right cheek 1 month ago. The excisional biopsy demonstrated molluscum contagiosum and decreased basal layer pigmentation on Fontana-Masson stain. The halo phenomenon is often associated with an acquired nevus cell nevus, but has also been associated with a congenital nevus cell nevus, non-neuroectodermal lesions such as angiomas, seborrheic keratoses, lichen planus, sarcoid, psoriasis, involuting flat warts, and histiocytoma. Our patient had an unusual association of molluscum contagiosum with the halo phenomenon. We suppose that the halo phenomenon in this patient might have been provoked by the molluscum contagiosum virus. A halo nevus-like appearance suggests the possibility of disease other than nevus. In such cases, skin biopsy is required for confirmation.