Experience With Molluscum Contagiosum and Associated Inflammatory Reactions in a Pediatric Dermatology Practice

Abstract

To investigate the frequency, epidemiology, clinical features, and prognostic significance of inflamed molluscum contagiosum (MC) lesions, molluscum dermatitis, reactive papular eruptions resembling Gianotti-Crosti syndrome, and atopic dermatitis in patients with MC. Design: Retrospective medical chart review. Setting: University-based pediatric dermatology practice. Patients: A total of 696 patients (mean age, 5.5 years) with molluscum. Main Outcome Measures: Frequencies, characteristics, and associated features of inflammatory reactions to MC in patients with and without atopic dermatitis. Results: Molluscum dermatitis, inflamed MC lesions, and Gianotti-Crosti syndrome-like reactions (GCLRs) occurred in 270 (38.8%), 155 (22.3%), and 34 (4.9%) of the patients, respectively. A total of 259 patients (37.2%) had a history of atopic dermatitis. Individuals with atopic dermatitis had higher numbers of MC lesions (P Ͻ .001) and an increased likelihood of molluscum dermatitis (50.6% vs 31.8%; P Ͻ.001). In patients with molluscum dermatitis, numbers of MC lesions increased during the next 3 months in 23.4% of those treated with a topical corticosteroid and 33.3% of those not treated with a topical corticosteroid, compared with 16.8% of patients without dermatitis. Patients with inflamed MC lesions were less likely to have an increased number of MC lesions over the next 3 months than patients without inflamed MC lesions or dermatitis (5.2% vs 18.4%; P Ͻ.03). The GCLRs were associated with inflamed MC lesion (PϽ .001), favored the elbows and knees, tended to be pruritic, and often heralded resolution of MC. Two patients developed unilateral laterothoracic exanthemlike eruptions. Conclusions: Inflammatory reactions to MC, including the previously underrecognized GCLR, are common. Treatment of molluscum dermatitis can reduce spread of MC via autoinoculation from scratching, whereas inflamed MC lesions and GCLRs reflect cell-mediated immune responses that may lead to viral clearance.

Autoimplantation therapy for the management of extensive molluscumcontagiosum: a novel treatment approach

“…Also, different immunotherapeutic agents for intralesional injection (including autogenous vaccine, Candida antigen, mumps antigen, trichophytin skin test antigen, tuberculin, BCG vaccine, MMR vaccine, Mycobacterium w vaccine and interferon alpha and gamma injection) have proven useful in warts. 17 As in warts, multiple studies 18,19 explain that in MC, cell mediated immunity is most important in modulation and controlling the infection. A study by Vermi 20 & colleagues presented evidence of brisk immunological response as a mechanism of self-destruction of the inflammatory MC lesions.…”

Infectious Diseases and Infestations of the Vulva

“…Cytological identifi cation of the typical intracytoplasmic inclusion bodies (molluscum bodies or Henderson-Patterson bodies) within scrapings from the interior of molluscum papule is suffi cient to confi rm the diagnosis. Molluscum dermatitis (eczematous reaction to the viral infection) and Gianotti-Crosti-like reactions (erythematous papules or papulovesicles) can be seen in these patients [ 37 ]. Classically, lesions of molluscum contagiosum commonly regress within 6-12 months.…”

Molluscum contagiosum and associations with atopic eczema in children: a retrospective longitudinal study in primary care

“…7 Furthermore, no studies have described primary care management, including prescribing and referrals to secondary care. 8 Atopic eczema (AE) has been found to be common in children with MC, [9][10][11][12][13] and the prevalence of AE is higher in children with MC than in the general population. 14,15 However, most studies describing this association have been based in specialty dermatology clinics, 12 and have not explored the temporal relationship between the two conditions.…”