Atopic dermatitis, impaired cellular immunity, and molluscum contagiosum

Abstract

A substantial elevation in the level of serum IgE (7,000 to 19,000 ng/ml) was noted in a man with atopic dermatitis and chronic molluscum contagiosum. Cell-mediated immunity (CMI) was depressed in vivo (cutaneous anergy), whereas in vitro tests showed normal numbers of "T" rosette-forming lymphocytes, a normal phytohemagglutinin-P-elicited lymphocyte transformation response, and lymphocyte transformation reactivity to the antigens streptokinase-streptodornase and purified protein derivative. Accumulated evidence suggests that patients with atopic dermatitis may have, associated with an elevated serum IgE level, a functional defect(s) in CMI that is greater in vivo than in vitro. This functional defect may impair host defense and account for the chronic molluscum contagiosum infection present in this patient.

The epidemiology of molluscum contagiosum in children

“…30,31,34 However, the extent of this association has not been quantified clinically, and different studies come to different conclusions. In this study, 24.2% of the patients were diagnosed with concomitant AD at the time of diagnosis of the MC.…”

“…29,30 The increased prevalence and severity of MC in this patient population have been linked to the relative suppression of the helper T-cell type 1 responses in acute skin lesions of AD. [31][32][33][34] MC has also been associated with systemic iatrogenic immunosuppression from administration of corticosteroids and chemotherapy. 35 The epidemiology and features of clinical presentation of MC infection in children and the association of MC to immunosuppression and AD are poorly understood.…”

The Incidence of Molluscum contagiosum among American Indians and Alaska Natives

“…Persons with atopic dermatitis (i.e., eczema) are generally considered to be at greater risk for contracting MC due to immune deficits, compromised skin integrity, or both [2]–[4]. However, investigations into the association between atopic dermatitis and molluscum infection have been observational in nature and have principally addressed the conditions only in children.…”

Identification and genotyping of molluscum contagiosum virus from genital swab samples by real-time PCR and Pyrosequencing

“…Transmission requires direct contact with infected skin or contaminated fomites (Postlethwaite, 1970). Molluscum contagiosum usually affects children, but is often associated with compromised immunity (Pauly et al, 1978). Molluscum contagiosum is also an increasing problem in sexually active individuals (Becker et al, 1986).…”