Interferon alpha treatment of molluscum contagiosum in immunodeficiency.
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A sister (aged 6 years) and brother (aged 8 years) presented four months apart with severe molluscum contagiosum. Both children demonstrated clinical and laboratory evidence of combined immunodeficiency. The extent of skin involvement by molluscum contagiosum precluded conventional treatment as well as intralesional interferon alpha (IFN alpha). Both subjects responded well to subcutaneous IFN alpha. (+info)
Molluscum contagiosum and warts.
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Molluscum contagiosum and warts are benign epidermal eruptions resulting from viral infections of the skin. Molluscum contagiosum eruptions are usually self-limited and without sequelae, although they can be more extensive in immunocompromised persons. Spontaneous disappearance of lesions is the norm, but treatment by local destruction (curettage, cryotherapy, or trichloroacetic acid) or immunologic modulation can shorten the disease course, possibly reducing autoinoculation and transmission. Warts result from a hyperkeratotic reaction to human papillomavirus infection; nongenital warts are classified as common, periungual, flat, filiform, or plantar, based on location and shape. Warts are treated by local destruction (acids, cryotherapy, electrodesiccation-curettage), chemotherapy, or immunotherapy. The choice of treatment varies with the age and wishes of the patient, the potential side effects of the treatment, and the location of the lesions. (+info)
Clinical profile of molluscum contagiosum in children versus adults.
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Molluscum contagiosum mainly affects children, but in adults the advent of HIV has modified its clinical spectrum. Our study is designed to ascertain the clinical profile of molluscum contagiosum in children and adults and to discover the effects of underlying HIV infection. During the study period of September 2000 to June 2002, 150 cases of molluscum contagiosum are screened and recruited at the Department of Dermatology and STD, JIPMER, Pondicherry. These include 137 children (85 male, 52 female) and 13 adults (10 male, 3 female). In children molluscum contagiosum is most commonly seen in the 5-10-year age group (58 cases), followed by the 1-5-year age group (53 cases), the 10-14-year age group (23 cases), and the younger-than-1-year age group (3 cases). In adults molluscum contagiosum is most commonly seen in the 14-20-year age group, followed by 2 cases each in the age groups 20-26 years, 26-34 years, and 34-40 years. The male-to-female sex ratio was 1.6:1 in children and 3.3:1 in adults. In both children and adults the most common sites affected are the head and neck, followed by trunk, upper extremity, genitalia, and lower extremity. It appears that the distribution of molluscum in our patients is significantly affected by the high proportion of HIV-positive adults in our sample. Seropositivity for HIV by ELISA is found in 1 of 137 children and 8 of 13 adults. In these HIV-positive patients, 2 cases of giant molluscum and one furuncle-like presentation are seen. (+info)
The incidence of molluscum contagiosum, scabies and lichen planus.
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We aimed to describe the incidence of new episodes of molluscum contagiosum, scabies and lichen planus presenting to general practitioners in England and Wales. We examined data collected in a sentinel practice network (the Weekly Returns Service of the Royal College of General Practitioners) in which about half a million persons were observed each year over the period 1994-2003. The incidence of molluscum contagiosum in males was 243/100,000 person-years and in females 231; of scabies, males 351, females 437; of lichen planus, males 32, females 37. Incidence varied by year and age. Ninety per cent of molluscum contagiosum episodes were reported in children aged 0-14 years, where incidence in 2000 (midpoint of a 6-year period of stable incidence) was 1265/100,000 (95% CI 1240-1290). Scabies affected all ages and annual incidence ranged between 233 (95% CI 220-246) in 2003 and 470 (95% CI 452-488) in 2000. Lichen planus occurred chiefly in persons aged over 45 years: incidence (all ages) ranged between 27 (95% CI 23-31) in 2003 and 43 (95% CI 37-49) in 1998. The relative risk of female to male incidence (all ages) of molluscum contagiosum was 0.95 (95% CI 0.91-0.99); of scabies 1.25 (95% CI 1.21-1.28); and of lichen planus 1.19 (95% CI 1.08-1.13). (+info)
Specimens from a vesicular lesion caused by molluscum contagiosum virus produced a cytopathic effect in cell culture that mimicked that produced by herpes simplex virus.
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Infection with molluscum contagiosum virus, a poxvirus, normally has a typical clinical presentation; therefore, laboratory confirmation is infrequently sought and the virus is rarely isolated in culture. As reported herein, viral culture of specimens from atypical lesions may produce an abortive infection in limited cell lines and a cytopathic effect suggestive of herpes simplex virus. (+info)
Interferon-alpha treatment of molluscum contagiosum in a patient with hyperimmunoglobulin E syndrome.
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We report widely disseminated molluscum contagiosum that occurred in a 9-year-old boy secondary to hyperimmunoglobulin E syndrome, a primary immunodeficiency disorder. Cutaneous examination revealed numerous, widespread, skin-colored to translucent, firm, umbilicated papules of varying sizes. They were distributed throughout the perineal and gluteal areas and bilaterally over his lower limbs. A biopsy specimen from his skin lesion demonstrated lobulated epidermal growth that consisted of keratinocytes with large intracytoplasmic eosinophilic inclusion bodies and a central crater. These findings were consistent with the diagnosis of molluscum contagiosum. Many treatments for his skin lesions were ineffective, including physical destruction or manual extrusion of the lesions; cryotherapy; curettage; and topical therapies with phenol, trichloroacetic acid, and imiquimod. The patient was treated successfully with subcutaneous interferon-alpha for 6 months without any adverse effect. (+info)
TLR activation of Langerhans cell-like dendritic cells triggers an antiviral immune response.
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Langerhans cells (LC) are a unique subset of dendritic cells (DC), present in the epidermis and serving as the first line of defense against pathogens invading the skin. To investigate the role of human LCs in innate immune responses, we examined TLR expression and function of LC-like DCs derived from CD34+ progenitor cells and compared them to DCs derived from peripheral blood monocytes (monocyte-derived DC; Mo-DC). LC-like DCs and Mo-DCs expressed TLR1-10 mRNAs at comparable levels. Although many of the TLR-induced cytokine patterns were similar between the two cell types, stimulation with the TLR3 agonist poly(I:C) triggered significantly higher amounts of the IFN-inducible chemokines CXCL9 (monokine induced by IFN-gamma) and CXCL11 (IFN-gamma-inducible T cell alpha chemoattractant) in LC-like DCs as compared with Mo-DCs. Supernatants from TLR3-activated LC-like DCs reduced intracellular replication of vesicular stomatitis virus in a type I IFN-dependent manner. Finally, CXCL9 colocalized with LCs in skin biopsy specimens from viral infections. Together, our data suggest that LCs exhibit a direct antiviral activity that is dependent on type I IFN as part of the innate immune system. (+info)
T-cell memory: the importance of chemokine-mediated cell attraction.
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A recent study demonstrates the involvement of certain chemokines in immune response initiation and CD8+ T-cell memory formation. These seminal findings broaden our understanding of the role of chemokines in adaptive immune processes. (+info)