Molluscum Contagiosum of the Gluteal Cleft: Observations and Implications for Management in Five Children

Abstract

Molluscum contagiosum (MC) is a common, self-limited skin infection caused by a double-stranded DNA virus of the family Poxviridae. Although the morphology of the disease is well described, MC presenting at unusual sites can exhibit atypical morphology, resulting in misdiagnosis. This observational, retrospective case series discusses the novel morphology of MC presenting in the intergluteal cleft of five children seen in the outpatient dermatology clinic of an academic medical center. We present this case series to highlight this novel presentation of MC in children and to emphasize a conservative approach to management given the sensitive location and the self-limited nature of the infection.

Intralesional immunotherapy for molluscum contagiosum: A review

“…Of note, some patients were receiving simultaneous liquid nitrogen therapy 5 . Additionally, a case study of a 19‐month‐old patient with MC also demonstrated significant improvement to intralesional Candida antigen 8 . Lesions cleared within 3 months of the therapy without recurrence.…”

“…Advantages with intralesional immunotherapy include prevention of recurrence and treatment of recalcitrant lesions. No recurrence was seen in all patients who completely responded to Candida, MMR vaccine, OK‐432, and vitamin D3 6‐9,11,13,14 . Intralesional PPD and interferon α may be an inferior choice in preventing recurrences 10,12 .…”

“…Intralesional immunotherapy is effective in pediatric and immunocompromised patients, with case reports showing complete resolution with Candida antigen, 8,13 MMR vaccine, 9 vitamin D3, 11 and OK‐432 14 . While treatment was successful, further investigations are necessary to assess efficacy due to the limited number of studies available.…”

“…5 Additionally, a case study of a 19-month-old patient with MC also demonstrated significant improvement to intralesional Candida antigen. 8 Lesions cleared within 3 months of the therapy without recurrence. There was no significant difference in recurrence between PPD and cantharidin (25% vs 20%).…”

“…No recurrence was seen in all patients who completely responded to Candida, MMR vaccine, OK-432, and vitamin D3. [6][7][8][9]11,13,14 Intralesional PPD and interferon α may be an inferior choice in preventing recurrences. 10,12 Patients who had complete resolution of lesions following intralesional therapy had previously failed treatment with imiquimod, with cryotherapy, which could bias the results and overestimate the effectiveness of the treatment.…”