Molluscum Contagiosum Dermatopathology
Molluscum contagiosum exhibits intraepidermal lobules with central cellular and viral debris. In the basal layer, enlarged basophilic nuclei and mitotic figures are seen. Progressing upward, the cells show cytoplasmic vacuolization and then eosinophilic globules. The nucleus becomes compressed at the level of the granular cell layer, and the molluscum bodies lose their internal structural markings.
Undisrupted lesions show an absence of inflammation, but dermal changes can include an infiltrate that is lymphohistiocytic, neutrophilic, or granulomatous. The latter has been seen in solitary lesions. Antibody to MCV by indirect immunofluorescence has been found in 69% of patients with visible lesions. Polymerase chain reaction can detect MCV in skin lesions.
Currently, there is no in-vitro or animal model for MCV. MCV can undergo an abortive infection in some cell lines, which can cause confusion with herpes simplex virus by laboratories. Two sets of investigators have infected human skin with molluscum contagiosum and grafted it onto athymic mice, although there was no continued viral replication.
MCV produces a papular eruption of multiple umbilicated lesions. The individual lesions are discrete, smooth, and dome shaped. They are generally skin colored with an opalescent character. The central depression or umbilication contains a white, waxy curdlike core. The size of the papule is variable, depending upon the stage of development, usually averaging 2-6 mm. Papules may exceed 1 cm in size in immunosuppressed hosts.
The papules may become inflamed spontaneously or after trauma and present atypically in size, shape, and color. The lesions are often grouped in small areas but may also become widely disseminated. Any cutaneous surface may be involved, but favored sites include the axillae, the antecubital and popliteal fossae, and the crural folds. Rarely, MCV lesions occur in the mouth or conjunctivae. Autoinoculation is common.
Children usually acquire molluscum nonsexually at both genital and nongenital areas. MCV in adults affects the groin, genital area, thighs, and lower abdomen and is often acquired sexually. Around 10% of cases develop an eczematous dermatitis around the lesions, but this disappears as the infection resolves. Patients with atopic dermatitis can have a disseminated eruption. Eruptions in immunocompromised individuals are very resistant to treatment.
The clinical appearance of molluscum contagiosum is in most cases diagnostic. Though molluscum cannot be cultured in the laboratory, histological examination of a curetted or biopsied lesion can also aid in the diagnosis in cases that are not clinically obvious. Immunohistochemical methods using a polyclonal antibody allows recognition of molluscum contagiosum in fixed tissue.
The thick white central core can be expressed and smeared on a slide and left unstained or stained with Geimsa, Gram, Wright, or Papanicolaou stains to demonstrate the large brick-shaped inclusion bodies. Electron microscopy has also been used to demonstrate the poxvirus structures. In-situ hybridization for MCV DNA has also been utilized.
Molluscum contagiosum lesions must be differentiated from verruca vulgaris, condyloma accuminata, varicella, herpes simplex, papillomas, epitheliomas, pyoderma, cutaneous cryptococcosis, epidermal inclusion cyst, basal cell carcinoma, papular granuloma annulare, keratoacanthoma, lichen planus, and syringoma or other adenexal tumors.
Viruses exhibit rapid rates of mutation which can make immunity difficult to sustain. Once a cell is infected it is difficult to selectively inhibit the virus without harming the host cell. As a result, research on possible molluscum treatments have focused on plants as strong allies in restoring immune strength and inhibiting the spread of viral diseases.
Some of the most impressive results consistently achieved in medicinal plants are in the elimination of viruses. The antiviral activity of our signature molluscum treatment, AntiMolluscum-Rx, is well documented and principally due to its direct virucidal effects. This is a potent yet safe anti-viral agent for topical use to eradicate molluscum infections.
AntiMolluscum-Rx is particularly invaluable not only in consideration of its ability to inactivate the extra cellular molluscum virus at very low concentrations, but also for its tolerability to healthy surrounding tissue, which makes this product so important in today's pharmacopeia. To learn more, please go to http://www.naturespharma.org.
Undisrupted lesions show an absence of inflammation, but dermal changes can include an infiltrate that is lymphohistiocytic, neutrophilic, or granulomatous. The latter has been seen in solitary lesions. Antibody to MCV by indirect immunofluorescence has been found in 69% of patients with visible lesions. Polymerase chain reaction can detect MCV in skin lesions.
Currently, there is no in-vitro or animal model for MCV. MCV can undergo an abortive infection in some cell lines, which can cause confusion with herpes simplex virus by laboratories. Two sets of investigators have infected human skin with molluscum contagiosum and grafted it onto athymic mice, although there was no continued viral replication.
MCV produces a papular eruption of multiple umbilicated lesions. The individual lesions are discrete, smooth, and dome shaped. They are generally skin colored with an opalescent character. The central depression or umbilication contains a white, waxy curdlike core. The size of the papule is variable, depending upon the stage of development, usually averaging 2-6 mm. Papules may exceed 1 cm in size in immunosuppressed hosts.
The papules may become inflamed spontaneously or after trauma and present atypically in size, shape, and color. The lesions are often grouped in small areas but may also become widely disseminated. Any cutaneous surface may be involved, but favored sites include the axillae, the antecubital and popliteal fossae, and the crural folds. Rarely, MCV lesions occur in the mouth or conjunctivae. Autoinoculation is common.
Children usually acquire molluscum nonsexually at both genital and nongenital areas. MCV in adults affects the groin, genital area, thighs, and lower abdomen and is often acquired sexually. Around 10% of cases develop an eczematous dermatitis around the lesions, but this disappears as the infection resolves. Patients with atopic dermatitis can have a disseminated eruption. Eruptions in immunocompromised individuals are very resistant to treatment.
The clinical appearance of molluscum contagiosum is in most cases diagnostic. Though molluscum cannot be cultured in the laboratory, histological examination of a curetted or biopsied lesion can also aid in the diagnosis in cases that are not clinically obvious. Immunohistochemical methods using a polyclonal antibody allows recognition of molluscum contagiosum in fixed tissue.
The thick white central core can be expressed and smeared on a slide and left unstained or stained with Geimsa, Gram, Wright, or Papanicolaou stains to demonstrate the large brick-shaped inclusion bodies. Electron microscopy has also been used to demonstrate the poxvirus structures. In-situ hybridization for MCV DNA has also been utilized.
Molluscum contagiosum lesions must be differentiated from verruca vulgaris, condyloma accuminata, varicella, herpes simplex, papillomas, epitheliomas, pyoderma, cutaneous cryptococcosis, epidermal inclusion cyst, basal cell carcinoma, papular granuloma annulare, keratoacanthoma, lichen planus, and syringoma or other adenexal tumors.
Viruses exhibit rapid rates of mutation which can make immunity difficult to sustain. Once a cell is infected it is difficult to selectively inhibit the virus without harming the host cell. As a result, research on possible molluscum treatments have focused on plants as strong allies in restoring immune strength and inhibiting the spread of viral diseases.
Some of the most impressive results consistently achieved in medicinal plants are in the elimination of viruses. The antiviral activity of our signature molluscum treatment, AntiMolluscum-Rx, is well documented and principally due to its direct virucidal effects. This is a potent yet safe anti-viral agent for topical use to eradicate molluscum infections.
AntiMolluscum-Rx is particularly invaluable not only in consideration of its ability to inactivate the extra cellular molluscum virus at very low concentrations, but also for its tolerability to healthy surrounding tissue, which makes this product so important in today's pharmacopeia. To learn more, please go to http://www.naturespharma.org.
