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Molluscum Contagiosum: New Insights, New Directions

Molluscum Contagiosum: New Insights, New Directions Abstract WITH THE eradication of smallpox, molluscum contagiosum (MC) virus (MCV) became the last remaining member of the Poxviridae family to specifically infect humans.1-3 Unlike the related poxviruses variola and vaccinia, MCV received little attention, since infection resulted in benign cutaneous neoplasms that were usually self-limited or easily controlled. All that changed with the advent of the acquired immunodeficiency syndrome (AIDS), as extensive and recalcitrant MC emerged as an important cause of morbidity and disfigurement.4-8 Physicians who treat MC in human immunodeficiency virus (HIV)— infected individuals have been frustrated by the lack of effective antiviral therapy and the inexorable progression of MC lesions as patients enter the late stages of HIV disease.5,6,8 Fortunately, recent basic knowledge about poxviruses, through sequencing of the MCV genome,9 as well as advances in the therapy of HIV-infected patients,10,11 gives reasons for optimism. Poxviruses wereamong the first groups of infectious agents to be morphologically defined by their effect References 1. Buller RML, Palumbo GJ. Poxvirus pathogenesis . MicrobiolRev. 1991;55:80-122. 2. Moss B. Poxviridae and their replication . In: Fields BN, Knipe DM, Melnick JL, et al, eds. Virology. 2nd ed. New York, NY: Raven Press; 1990:chap 74. 3. Fenner F. Poxviruses . In: Fields BN, Knipe DM, Melnick JL, et al, eds. Virology. 2nd ed. New York, NY: Raven Press; 1990:chap 75. 4. Lombardo PC. Molluscum contagiosum and the acquired immunodeficiency syndrome . Arch Dermatol. 1985;121:834-835.Crossref 5. Schwartz JJ, Myskowski PL. Molluscum contagiosum in patients with human immunodeficiency virus infection: a review of twenty-seven patients . J Am Acad Dermatol. 1992;27:583-588.Crossref 6. Koopman RJJ, Van Merrien boer FCJ, Vreden SGS, Dolmans WMV. Molluscum contagiosum: a marker for advanced HIV infection . Br J Dermatol. 1992;126:528-529.Crossref 7. Gottlieb SL, Myskowski PL. Molluscum contagiosum . Int J Dermatol. 1994;33: 453-461.Crossref 8. Cronin TA, Resnik BI, Elgart G, et al. Recalcitrant giant molluscum contagiosum in a patient with AIDS. J Am Acad Dermatol. 1996;35:266-267.Crossref 9. Senkevich TG, Bugert JJ, Sisler JR, Koonln EV, Darai G, Moss B. Genome sequence of a human tumorigenic poxvirus: prediction of specific host responseevasion genes . Science. 1996;273:813-816.Crossref 10. Bartlett JG. Protease inhibitors for HIV infection . Ann Intern Med. 1996;124: 1086-1088.Crossref 11. Deeks SG, Smith M, Holodniy M, Kahn JO. HIV-1 protease inhibitors: a review for clinicians . JAMA. 1997;277:145-153.Crossref 12. Porter CD, Archard LC. Characterization and physical mapping of molluscum contagiosum virus DNA and location of a sequence capable of encoding a conserved domain of epidermal growth factor . J Gen Virol. 1987;68:673-682.Crossref 13. Viac J, Chardonnet Y. Immunocompetent cells and epithelial cell modifications in molluscum contagiosum . J Cutan Pathol. 1990;17:202-205.Crossref 14. Douglas JD, Tanner KN, Prine JR, van Riper DC, Derwells SK. Molluscum contagiosum in chimpanzees . J Am Vet Med Assoc. 1967;151:901-904. 15. Bagnall BG, Wilson GR. Molluscum contagiosum in a red kangaroo . Australas J Dermatol. 1974;15:115-118.Crossref 16. Van Rensburg IB, Collett MG, Ronen N, Gerdes T. Molluscum contagiosum in a horse . J S Afr Vet Assoc. 1991;62:72-74. 17. Buller RM, Burnett J, Chen W, Kreider J. Replication of molluscum contagiosum virus . Virology. 1995;213:655-659.Crossref 18. Fife KH, Whitfield M, Faust H, Goheen MP, Bryan J, Brown DR. Growth of a molluscum contagiosum virus in a human foreskin xenograft model . Virology. 1996; 226:95-101.Crossref 19. Pinkus H, Frisch D. Inflammatory reactions to molluscum contagiosum, possibly of immunologic nature . J Invest Dermatol. 1949;13:289-294.Crossref 20. Reed RJ, Parkinson RP. The histogenesis of molluscum contagiosum . Am J Surg Pathol. 1977;1:161-166.Crossref 21. Weinberg JM, Mysliwiec A, Turiansky GW, Redfield R, James WD. Viral folliculitis: atypical presentations of herpes simplex, herpes zoster, and mollusum contagiosum . Arch Dermatol. 1997;133:983-986.Crossref 22. Heng MCY, Steuer ME, Levy A, et al. Lack of host cellular immune response in eruptive molluscum contagiosum . Am J Dermatopathol. 1989;11:248-254.Crossref 23. Bhawan J, Dayal Y, Bhan AK. Langerhans cells in molluscum contagiosum, verruca vulgaris, plantar wart, and condyloma acuminatum . J Am Acad Dermatol. 1986;15:646-649.Crossref 24. Shelley WB, Burkmeister V. Demonstration of a unique viral structure: the molluscum viral colony sac . Br J Dermatol. 1986;115:557-562.Crossref 25. Steffen C, Markman J. Spontaneous disappearance of molluscum contagiosum . Arch Dermatol. 1980;116:923-924.Crossref 26. Henao M, Freeman RG. Inflammatory molluscum contagiosum: clinicopathological study of seven cases . Arch Dermatol. 1964;90:479-482.Crossref 27. Charteris DG, Bonshek, Tullo AB. Ophthalmic molluscum contagiosum: clinical and immunopathological features . Br J Ophthalmol. 1995;79:476-481.Crossref 28. Pauly CR, Artis WM, Jones HE. Atopic dermatitis, impaired cellular immunity, and molluscum contagiosum . Arch Dermatol. 1978;114:391-393.Crossref 29. Slawsky LD, Gilson RT, Hockley AJ, Libow LF. Epidermodysplasia verruciformis associated with severe immunodeficiency . J Am Acad Dermatol. 1992;27:448-456.Crossref 30. Mayuma H, Yamaoka K, Tsutsui T, et al. Selective immunoglobulin M deficiency associated with disseminated molluscum contagiosum . Eur J Pediatr. 1986;145: 99-103.Crossref 31. Cotton DWK, Cooper C, Barrett DF, Leppard BJ. Severe atypical molluscum contagiosum infection in an immunocompromised host . Br J Dermatol. 1987;116: 871-876.Crossref 32. Smith DK, Neal JJ, Holmberg SD, and the Centers for Disease Control Idiopathic CD4+ T-Lymphocytopenia Task Force. Unexplained opportunistic infections and CD4+ T-lymphocytopenia without HIV infection: an investigation in the United States . N Engl J Med. 1993;328:373-379.Crossref 33. Spira TJ, Jones BM, Nicholson JKA, et al. Idiopathic CD4+ T-lymphocytopenia: four patients with opportunistic infections and no evidence of HIV infection . N Engl J Med. 1993;328:386-392.Crossref 34. Telner P, Solomon LM. Eruptive molluscum contagiosum in atopic dermatitis . Can Med Assoc J. 1966;95:978-979. 35. Hellier FF. Profuse mollusca contagiosa of the face induced by corticosteroids . Br J Dermatol. 1971;85:398.Crossref 36. Rosenberg EW, Yusk JW. Molluscum contagiosum: eruption following treatment with prednisone and methotrexate . Arch Dermatol. 1970;101:439-441.Crossref 37. Reynaud-Mendel B, Janier M, Gerbaka J, et al. Dermatologic findings in HIV-1— infected patients: a prospective study with emphasis in CD4+ cell count . Dermatology. 1996;192:325-328.Crossref 38. Goldstein B, Berman B, Sukenik E, Frankel SJ. Correlation of skin disorders with CD4 lymphocyte count in patients with HIV/AIDS . J Am Acad Dermatol. 1997; 36:262-264.Crossref 39. Smith KJ, Skelton HG, Yeager J, et al. Molluscum contagiosum: ultrastructural evidence for its presence in skin adjacent to clinical lesions in patients infected with human immunodeficiency virus type 1 . Arch Dermatol. 1992;128:223-227.Crossref 40. Belsito DV, Sanchez MR, Baer RL, et al. Reduced Langerhans' cell la antigen and ATPase activity in patients with the acquired immunodeficiency syndrome . N Engl J Med. 1984;310:1279-1282.Crossref 41. Fivenson DP, Weltman RE, Gibson SH. Giant molluscum contagiosum presenting as basal cell carcinoma in an acquired immunodeficiency syndrome patient . J Am Acad Dermatol. 1988;19:912-914.Crossref 42. Schwartz JJ, Myskowski PL. HIV-related molluscum contagiosum presenting as a cutaneous horn . Int J Dermatol. 1992;31:142-144.Crossref 43. Smith KJ, Skelton HG, Yeager J, et al. Histopathologic and immunohistochemical findings associated with inflammatory dermatoses in human immunodeficiency virus type 1 disease and their correlation with Walter Reed stage . J Am Acad Dermatol. 1993;28:174-184.Crossref 44. Meadows KP, Tyring SK, Pavia AT, Rallis TM. Resolution of recalcitrant molluscum contagiosum virus lesions in human immunodeficiency virus-infected patients treated with cidofovir . Arch Dermatol. 1997;133:987-990.Crossref 45. Garrett SJ, Robinson JK, Roenigk HH. Trichloracetic acid peel of molluscum contagiosum in immunocompromised patients . J Dermatol Surg Oncol. 1992;18: 855-858.Crossref 46. Funt TR. Catharidin treatment of molluscum contagiosum . Arch Dermatol. 1961; 83:504-505.Crossref 47. Syed TA, Lundin S, Ahmad M. Topical 0.3% and 0.5% podophyllotoxin cream for self-treatment of molluscum contagiosum in males . Dermatology . 1994;189: 65-68.Crossref 48. Moss B, Rosenblum EN, Katz E, Grimley PM. Rifampicin: a specific inhibitor of vaccinia virus assembly . Nature. 1969;224:1280-1284.Crossref 49. Kane EM, Shuman S. Adenosine N1-oxide inhibits vaccinia virus replication by blocking translation of viral early mRNAS . J Virol. 1995;69:6352-6358. 50. Murphy M, Armstrong, DA Sepkowitz KA, Ahkami R, Myskowski PL. Regression of AIDS-related Kaposi's sarcoma following treatment with an HIV-1 protease inhibitor . AIDS. 1997;11:261-262. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Molluscum Contagiosum: New Insights, New Directions

Archives of Dermatology , Volume 133 (8) – Aug 1, 1997

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Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1997.03890440123020
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Abstract

Abstract WITH THE eradication of smallpox, molluscum contagiosum (MC) virus (MCV) became the last remaining member of the Poxviridae family to specifically infect humans.1-3 Unlike the related poxviruses variola and vaccinia, MCV received little attention, since infection resulted in benign cutaneous neoplasms that were usually self-limited or easily controlled. All that changed with the advent of the acquired immunodeficiency syndrome (AIDS), as extensive and recalcitrant MC emerged as an important cause of morbidity and disfigurement.4-8 Physicians who treat MC in human immunodeficiency virus (HIV)— infected individuals have been frustrated by the lack of effective antiviral therapy and the inexorable progression of MC lesions as patients enter the late stages of HIV disease.5,6,8 Fortunately, recent basic knowledge about poxviruses, through sequencing of the MCV genome,9 as well as advances in the therapy of HIV-infected patients,10,11 gives reasons for optimism. Poxviruses wereamong the first groups of infectious agents to be morphologically defined by their effect References 1. Buller RML, Palumbo GJ. Poxvirus pathogenesis . MicrobiolRev. 1991;55:80-122. 2. Moss B. Poxviridae and their replication . In: Fields BN, Knipe DM, Melnick JL, et al, eds. Virology. 2nd ed. New York, NY: Raven Press; 1990:chap 74. 3. Fenner F. Poxviruses . In: Fields BN, Knipe DM, Melnick JL, et al, eds. Virology. 2nd ed. New York, NY: Raven Press; 1990:chap 75. 4. Lombardo PC. Molluscum contagiosum and the acquired immunodeficiency syndrome . Arch Dermatol. 1985;121:834-835.Crossref 5. Schwartz JJ, Myskowski PL. Molluscum contagiosum in patients with human immunodeficiency virus infection: a review of twenty-seven patients . J Am Acad Dermatol. 1992;27:583-588.Crossref 6. Koopman RJJ, Van Merrien boer FCJ, Vreden SGS, Dolmans WMV. Molluscum contagiosum: a marker for advanced HIV infection . Br J Dermatol. 1992;126:528-529.Crossref 7. Gottlieb SL, Myskowski PL. Molluscum contagiosum . Int J Dermatol. 1994;33: 453-461.Crossref 8. Cronin TA, Resnik BI, Elgart G, et al. Recalcitrant giant molluscum contagiosum in a patient with AIDS. J Am Acad Dermatol. 1996;35:266-267.Crossref 9. Senkevich TG, Bugert JJ, Sisler JR, Koonln EV, Darai G, Moss B. Genome sequence of a human tumorigenic poxvirus: prediction of specific host responseevasion genes . Science. 1996;273:813-816.Crossref 10. Bartlett JG. Protease inhibitors for HIV infection . Ann Intern Med. 1996;124: 1086-1088.Crossref 11. Deeks SG, Smith M, Holodniy M, Kahn JO. HIV-1 protease inhibitors: a review for clinicians . JAMA. 1997;277:145-153.Crossref 12. Porter CD, Archard LC. Characterization and physical mapping of molluscum contagiosum virus DNA and location of a sequence capable of encoding a conserved domain of epidermal growth factor . J Gen Virol. 1987;68:673-682.Crossref 13. Viac J, Chardonnet Y. Immunocompetent cells and epithelial cell modifications in molluscum contagiosum . J Cutan Pathol. 1990;17:202-205.Crossref 14. Douglas JD, Tanner KN, Prine JR, van Riper DC, Derwells SK. Molluscum contagiosum in chimpanzees . J Am Vet Med Assoc. 1967;151:901-904. 15. Bagnall BG, Wilson GR. Molluscum contagiosum in a red kangaroo . Australas J Dermatol. 1974;15:115-118.Crossref 16. Van Rensburg IB, Collett MG, Ronen N, Gerdes T. Molluscum contagiosum in a horse . J S Afr Vet Assoc. 1991;62:72-74. 17. Buller RM, Burnett J, Chen W, Kreider J. Replication of molluscum contagiosum virus . Virology. 1995;213:655-659.Crossref 18. Fife KH, Whitfield M, Faust H, Goheen MP, Bryan J, Brown DR. Growth of a molluscum contagiosum virus in a human foreskin xenograft model . Virology. 1996; 226:95-101.Crossref 19. Pinkus H, Frisch D. Inflammatory reactions to molluscum contagiosum, possibly of immunologic nature . J Invest Dermatol. 1949;13:289-294.Crossref 20. Reed RJ, Parkinson RP. The histogenesis of molluscum contagiosum . Am J Surg Pathol. 1977;1:161-166.Crossref 21. Weinberg JM, Mysliwiec A, Turiansky GW, Redfield R, James WD. Viral folliculitis: atypical presentations of herpes simplex, herpes zoster, and mollusum contagiosum . Arch Dermatol. 1997;133:983-986.Crossref 22. Heng MCY, Steuer ME, Levy A, et al. Lack of host cellular immune response in eruptive molluscum contagiosum . Am J Dermatopathol. 1989;11:248-254.Crossref 23. Bhawan J, Dayal Y, Bhan AK. Langerhans cells in molluscum contagiosum, verruca vulgaris, plantar wart, and condyloma acuminatum . J Am Acad Dermatol. 1986;15:646-649.Crossref 24. Shelley WB, Burkmeister V. Demonstration of a unique viral structure: the molluscum viral colony sac . Br J Dermatol. 1986;115:557-562.Crossref 25. Steffen C, Markman J. Spontaneous disappearance of molluscum contagiosum . Arch Dermatol. 1980;116:923-924.Crossref 26. Henao M, Freeman RG. Inflammatory molluscum contagiosum: clinicopathological study of seven cases . Arch Dermatol. 1964;90:479-482.Crossref 27. Charteris DG, Bonshek, Tullo AB. Ophthalmic molluscum contagiosum: clinical and immunopathological features . Br J Ophthalmol. 1995;79:476-481.Crossref 28. Pauly CR, Artis WM, Jones HE. Atopic dermatitis, impaired cellular immunity, and molluscum contagiosum . Arch Dermatol. 1978;114:391-393.Crossref 29. Slawsky LD, Gilson RT, Hockley AJ, Libow LF. Epidermodysplasia verruciformis associated with severe immunodeficiency . J Am Acad Dermatol. 1992;27:448-456.Crossref 30. Mayuma H, Yamaoka K, Tsutsui T, et al. Selective immunoglobulin M deficiency associated with disseminated molluscum contagiosum . Eur J Pediatr. 1986;145: 99-103.Crossref 31. Cotton DWK, Cooper C, Barrett DF, Leppard BJ. Severe atypical molluscum contagiosum infection in an immunocompromised host . Br J Dermatol. 1987;116: 871-876.Crossref 32. Smith DK, Neal JJ, Holmberg SD, and the Centers for Disease Control Idiopathic CD4+ T-Lymphocytopenia Task Force. Unexplained opportunistic infections and CD4+ T-lymphocytopenia without HIV infection: an investigation in the United States . N Engl J Med. 1993;328:373-379.Crossref 33. Spira TJ, Jones BM, Nicholson JKA, et al. Idiopathic CD4+ T-lymphocytopenia: four patients with opportunistic infections and no evidence of HIV infection . N Engl J Med. 1993;328:386-392.Crossref 34. Telner P, Solomon LM. Eruptive molluscum contagiosum in atopic dermatitis . Can Med Assoc J. 1966;95:978-979. 35. Hellier FF. Profuse mollusca contagiosa of the face induced by corticosteroids . Br J Dermatol. 1971;85:398.Crossref 36. Rosenberg EW, Yusk JW. Molluscum contagiosum: eruption following treatment with prednisone and methotrexate . Arch Dermatol. 1970;101:439-441.Crossref 37. Reynaud-Mendel B, Janier M, Gerbaka J, et al. Dermatologic findings in HIV-1— infected patients: a prospective study with emphasis in CD4+ cell count . Dermatology. 1996;192:325-328.Crossref 38. Goldstein B, Berman B, Sukenik E, Frankel SJ. Correlation of skin disorders with CD4 lymphocyte count in patients with HIV/AIDS . J Am Acad Dermatol. 1997; 36:262-264.Crossref 39. Smith KJ, Skelton HG, Yeager J, et al. Molluscum contagiosum: ultrastructural evidence for its presence in skin adjacent to clinical lesions in patients infected with human immunodeficiency virus type 1 . Arch Dermatol. 1992;128:223-227.Crossref 40. Belsito DV, Sanchez MR, Baer RL, et al. Reduced Langerhans' cell la antigen and ATPase activity in patients with the acquired immunodeficiency syndrome . N Engl J Med. 1984;310:1279-1282.Crossref 41. Fivenson DP, Weltman RE, Gibson SH. Giant molluscum contagiosum presenting as basal cell carcinoma in an acquired immunodeficiency syndrome patient . J Am Acad Dermatol. 1988;19:912-914.Crossref 42. Schwartz JJ, Myskowski PL. HIV-related molluscum contagiosum presenting as a cutaneous horn . Int J Dermatol. 1992;31:142-144.Crossref 43. Smith KJ, Skelton HG, Yeager J, et al. Histopathologic and immunohistochemical findings associated with inflammatory dermatoses in human immunodeficiency virus type 1 disease and their correlation with Walter Reed stage . J Am Acad Dermatol. 1993;28:174-184.Crossref 44. Meadows KP, Tyring SK, Pavia AT, Rallis TM. Resolution of recalcitrant molluscum contagiosum virus lesions in human immunodeficiency virus-infected patients treated with cidofovir . Arch Dermatol. 1997;133:987-990.Crossref 45. Garrett SJ, Robinson JK, Roenigk HH. Trichloracetic acid peel of molluscum contagiosum in immunocompromised patients . J Dermatol Surg Oncol. 1992;18: 855-858.Crossref 46. Funt TR. Catharidin treatment of molluscum contagiosum . Arch Dermatol. 1961; 83:504-505.Crossref 47. Syed TA, Lundin S, Ahmad M. Topical 0.3% and 0.5% podophyllotoxin cream for self-treatment of molluscum contagiosum in males . Dermatology . 1994;189: 65-68.Crossref 48. Moss B, Rosenblum EN, Katz E, Grimley PM. Rifampicin: a specific inhibitor of vaccinia virus assembly . Nature. 1969;224:1280-1284.Crossref 49. Kane EM, Shuman S. Adenosine N1-oxide inhibits vaccinia virus replication by blocking translation of viral early mRNAS . J Virol. 1995;69:6352-6358. 50. Murphy M, Armstrong, DA Sepkowitz KA, Ahkami R, Myskowski PL. Regression of AIDS-related Kaposi's sarcoma following treatment with an HIV-1 protease inhibitor . AIDS. 1997;11:261-262.

Journal

Archives of DermatologyAmerican Medical Association

Published: Aug 1, 1997

References