Clinic. Recommendations: Molluscum contagiosum

Molluscum contagiosum ICD-10: code B08.1 DEFINITION Molluscum contagiosum is a benign viral skin disease characterized by the appearance on the skin and mucous membranes of hemispherical nodules ranging in size from a pinhead to a pea with a central umbilical depression. ETIOLOGY AND KEY LINKS OF PATHOGENESIS The disease is caused by an orthopoxvirus, which belongs to the Poxviridae family, the Chordopoxviridae subfamily, the genus Molluscipoxvirus. Incubation period diseases from 1 week to several months, on average - 2-7 weeks. Molluscum contagiosum, unlike other poxvirus infections, is manifested by tumor-like growth of the epidermis, infected cells increase in size, burst and accumulate in the center of the rash elements. CLASSIFICATION None. CLINICAL PICTURE Clinical signs are characterized by a rash on the face, especially the eyelids, nose, neck, chest, the skin of the external genital organs, less often on the entire skin of single or multiple nodules with a diameter of 0.2-0.5 cm, which sometimes reach a size of 1.5 cm and more. In children, formations are more often localized on the face, trunk and limbs, in adults - on the skin of the lower abdomen, pubis, inner thighs, and the skin of the external genital organs. In rare cases, mucous membranes are affected. The defeat of the eyelids may be accompanied by conjunctivitis. Elements of molluscum contagiosum are hemispherical or slightly flattened nodules, dense, painless, normal skin color or pale pink, often with a waxy sheen, with an umbilical depression in the center. They are located in isolation on unchanged skin, less often surrounded by a weakly expressed inflammatory rim. When the nodules are squeezed from the sides, a white, crumbly (mushy) mass is released from the central opening, consisting of keratinized cells - "mollusk bodies". In the overwhelming majority of cases, these rashes are not accompanied by subjective sensations and represent only a cosmetic problem for the patient. Usually the disease is self-limiting and morphological elements, even without treatment, spontaneously disappear after a few months. However, very often, especially in children, there is a protracted course of molluscum contagiosum (from 6 months to 5 years) as a result of autoinaculation of the pathogen from the available morphological elements with a weakening of the immune system. SURVEY ALGORITHM ■ General analysis blood. ■ Microscopic examination (with an atypical clinical picture). ■ Histological examination (with an atypical clinical picture). ■ Immunological examination (with torpid course of the disease, frequent relapses). Differential diagnosis Multiple small elements of molluscum contagiosum - flat warts, genital warts, syringoma, hyperplasia of the sebaceous glands. A single large element of molluscum contagiosum - keratoacanthoma, squamous cell skin cancer, basal cell skin cancer, implantation cyst. TREATMENT Destruction of papular elements using tweezers, cryodestruction, electrocoagulation, radio wave surgery, CO laser. Subsequent stewing with 2–5% alcoholic solution of iodine, fucorcin (Castellani liquid), 1–2% alcoholic solution of brilliant green. Treatment efficacy criteria Complete clinical remission. Indications for hospitalization None. Most frequent mistakes in the treatment Late diagnosis, inadequate therapy. PREVENTION Avoid direct contact with patients.

Molluscum contagiosum manifests itself as an infectious dermatosis and is characterized by skin lesions. The disease manifests itself as small white or pink nodules with a depression in the middle. This disease is ubiquitous and can be contracted at any age. The virus is transmitted by contact with an infected person.

Molluscum contagiosum belongs to benign formations. It is formed by a virus that infects a small area of \u200b\u200bthe skin. The inflammatory process is not typical for nodules.

Classification of the disease according to mkb10

Doctors have developed ICB 10 to take into account the level of morbidity and mortality. Each disease is assigned a special code, which consists of letters and numbers.

The International Classifier of Diseases has given molluscum contagiosum code B08.1. Such accounting is necessary for convenient storage of the necessary medical information.

The causative agent is a virus containing human DNA and belonging to the poxvirus family.

The risk of infection increases in the following cases:

• Visiting the public pool, sauna.
• Close communication with an infected person.
• Decreased immunity.
• HIV infection.

The incubation period lasts from two weeks to several months. A person does not even always know that he is a carrier of the molluscum contagiosum virus. After the incubation period, the disease begins to progress.

Symptoms and Treatment

The virus enters the human body through microcracks and injuries. Children under 5 years of age are more likely to be infected. They have formations on the face, eyelids, neck, trunk. In adults, the infection is localized in the groin area, more often on the genitals, around the anus. Adults become infected through intimacy. The disease is diagnosed in 18% of HIV-infected people.

A characteristic feature of the disease is that when pressing on the nodule, a curd mass is released from the depression. Molluscs are located in groups or singly. Sometimes a person feels itching at the site of the rash.

The growths have different shapes and sizes. Molluscum contagiosum can be:

• giant sizes;
• keratinized;
• cystic;
• pronounced;
• resembling acne, milia.

dermatologiya.su

Molluscum contagiosum: ICD-10, photo, treatment in children and adults

Among children and adults, a viral disease called “ molluscum contagiosum ". Absolutely anyone can get it. Therefore, it is important to learn about the main reasons for the development of pathology and methods of its elimination.

What is this disease

The disease is a type of viral dermatosis, which is a flesh-colored rash with a pronounced depression in the center.

They occur in various places on the human body. May be amazed:

On contact with the skin, the virus may not appear immediately. Sometimes the first symptoms show themselves several months after infection.

When secretion is released and the skin heals, the patient experiences an itching sensation.

ICD-10 code

According to the International Classification of Diseases, molluscum contagiosum has the following ICD-10 code:

Causes of occurrence

Orthopoxvirus genus Molluscipoxvirus more often develops in people with weakened immunity, regardless of gender and age.

Therefore, its contact with the skin does not always lead to illness. You can protect yourself from infection by finding out the causes of the disease.

In men

A man can contract the virus through household items, personal belongings, shaking hands, touching. This often happens after an illness, the use of low-quality products.

Photos of rashes in men

The factors provoking the disease are:

• bad ecology;
• hIV epidemic;
• dense population of the region.

Intimate formations are the result of sexual contact with an infected partner. Viral particles can be transmitted through water, for example, when visiting a sauna, swimming pool, water park.

Among women

The causal factors and the course of the disease in women are no different from the manifestation of pathology in men.

Molluscum contagiosum on a woman's body: photo

This virus does not in any way affect the course of pregnancy of the expectant mother. In this case, nothing threatens the child's health.

In children

Children are especially susceptible to molluscum contagiosum. The main reason for the spread of infection among them is household contact with an infected child.

Photo of manifestation of cont. shellfish in children

It can happen in public placesah, among which:

At risk are children who have weakened immunity, for example, after an illness.

Treatment

Molluscum contagiosum therapy is not available in all cases. Usually, the rash goes away by itself within six months. If this period is prolonged, the neoplasm is eliminated in various ways.

Treatment in adults is carried out with the help of pharmaceutical preparations, folk remedies and surgical intervention.

Drug therapy

Usually, the following drugs are prescribed to treat the disease:

1. Homeopathic.
2. Antibiotics
3. Antiviral.
4. Immunomodulatory.
5. Vitamin complexes.

At home, you can use special creams and ointments:

For external use, alcohol solutions are used, for example, "Chlorophyllipt".

Modern ways of dealing with a contagious infection include removing the build-up with:

1. Laser. The method provides fast regeneration, painlessness and minimal skin damage.
2. Liquid nitrogen. Cryotherapy has no contraindications to its use, it promotes rapid tissue regeneration. Not suitable for small children.
3. Electrocoagulator. This is a quick and effective procedure, after which no scarring remains.
4. Tweezers or needles. The success of a mechanical intervention depends on the experience of the specialist. This method is not suitable for treating children. There is a risk of introducing another infection.

Surgery to remove growths

The method of treatment is selected by a dermatologist depending on the degree of the disease and the patient's health.

Folk remedies

Alternative treatments are affordable and safe, so many people prefer to use traditional medicine recipes.

Popular remedies include the following herbs and foods:

1. Garlic ... It is pounded into porridge and applied to the rash 3-4 times a day. Garlic should not be applied in the area of \u200b\u200bthe mucous membrane.
2. Succession ... 1.5 tablespoons of the plant are poured with a glass of boiling water and insisted overnight. Papules are rubbed with broth 4-5 times a day.
3. Celandine ... Prepare the infusion according to the previous recipe and wipe the affected areas three times a day.

Before using folk remedies, you need to make sure that there is no allergy.

For children

Treatment of infection in children involves the use of medications, folk recipes and pharmacological preparations. In some cases, it will be necessary to remove the papules. Most often, laser therapy is prescribed, which is absolutely harmless to the child. After this procedure, you cannot bathe your baby for 3 days. The recovery period requires adjustments in immunity.

Especially important during therapy body hygiene... Due to the fact that the pathogen is actively multiplying in water, you need to wash the child very quickly.

It is important to understand that self-treatment can make the situation worse. Therefore, the treatment method should be chosen by the attending pediatrician.

Preventive measures

It is not enough to know how to treat a disease, it is important to avoid subsequent infection.

Should adhere to preventive measuresopiumwhich include:

1. Compliance with the rules of hygiene.
2. Maintaining immunity.
3. Elimination of contact with infected people.
4. Disinfection of items and clothing.
5. Lack of casual sex in adults.

If one of the family members is sick, the rest should also be examined to eliminate the risk of infection.

It is important to monitor the condition of the baby's skin and examine it for suspicious rashes. At the first signs of the disease, the baby should be shown to the doctor in order to avoid complications in the future.

Molluscum contagiosum

Definition and background [edit]

Molluscum contagiosum (Molluscum contagiosum) is a viral disease characterized by the appearance on the skin of hemispherical nodules with a pearlescent hue.

Synonyms: Infectious epithelioma, epithelial molluscum.

The disease is ubiquitous and affects a person at any age. The infection is transmitted through direct contact with a sick person or a virus carrier, or indirectly through contaminated personal and household items.

The incubation period lasts from 15 days to several months.

Etiology and pathogenesis [edit]

The causative agent is a DNA-containing molluscum contagiosum virus (Molluscipoxvirus), pathogenic only for humans, belonging to the group of poxviruses.

Clinical manifestations [edit]

In children, the process is expressed on the skin of the face (more often on the eyelids and forehead area), neck, upper half of the chest (especially in the armpits), upper limbs (rear of the brushes); in adults - on the skin of the pubis, external genitals, around the anus, on the inner thighs. Multiple flat small nodules (0.1-0.2 cm) of the color of unchanged skin or yellow-gray appear on normal skin. In the center of the nodule there is an umbilical depression with a small hole. When pressed with tweezers on the nodule from the sides, a mushy curdled mass of whitish color, consisting of keratinized epithelial cells and pathogen bodies, is released from the central hole.

The nodes are located in groups or in isolation. There are no subjective feelings.

Possible atypical forms of molluscum contagiosum:

Giant (3 cm or more in diameter);

Looks like milia, acne, warts.

Molluscum Contagiosum: Diagnosis [edit]

Diagnosis is clinical. Squeezing out the mollusc bodies by pressing the lateral surfaces of the nodule with tweezers helps to recognize the disease.

Differential diagnosis [edit]

Differential diagnosis is carried out with warts (flat, vulgar), keratoacanthoma (with giant molluscs), milium, acne.

Molluscum Contagiosum: Treatment [edit]

Treatment consists in mechanical removal of the nodule.

The contents of the nodules are squeezed out with tweezers (a white dense mass is released from the umbilical depression), then the nodules are lubricated with iodine (iodine with an alcohol solution of 5-10%).

The contents of the nodule are scraped out with a curette and smeared with iodine (iodine with an alcohol solution of 5-10%).

The elements are lubricated with solutions of silver nitrate, feresol or triiodresorcinol (ryodoxol ointment).

Diathermocoagulation of nodules, cryodestruction with liquid nitrogen are performed.

Prevention [edit]

Isolation of sick children from the collective until complete recovery, adherence to the rules of personal and public hygiene.

Molluscum contagiosum

ICD code - 10
H 03.1 *

Signs and diagnostic criteria

Molluscum contagiosum (Molluscum contagiosum) - a viral lesion of the eyelid skin in the form of domed, dimpled, shiny nodules on the eyelids or along their edges.

Medical care levels:
The third level is an ophthalmic hospital.

Inspection:
1. External examination of the eyelids
2. Visometry
3. Biomicroscopy
4. Perimetry

Obligatory laboratory tests:
1. Complete blood count
2. Blood on RW
3. Hbs antigen
4. Time of blood clotting
5. General urine analysis

Specialist consultations on indications:
Dermatologist

Characteristics of therapeutic measures
Surgical treatment: removal of nodules by cutting, electrocoagulation, cryocoagulation.

Final expected result: recovery, cosmetic effect

Treatment period: - 3 days

Treatment quality criteria:
Lack of nodules

Possible side effects and complications:
Infection.

Requirements for dietary prescriptions and restrictions:
Not

Requirements for the regime of work, rest and rehabilitation:
The patient is disabled - 10 days
Further recommendations are an examination every 2-4 weeks until complete recovery.

Molluscum contagiosum

Brief description of the disease

As known, children's organism it resists the invasion of various bacteria and viruses much weaker than the body of a healthy adult. It means that modern medicine many diseases are known that mainly affect children. One of them is called "molluscum contagiosum".

Molluscum contagiosum is understood as a viral lesion of the epidermis, which is the response of the skin to the effect of the pathogen. As a rule, the virus is found in children, but with the coincidence of adverse factors (a serious illness, a weakened immunity), it is quite capable of developing on the body of an adult.

Molluscum contagiosum in children is transmitted after direct contact with an infected person, or when sharing common hygiene items and toys. If timely preventive measures are not taken, molluscum contagiosum in children can lead to the onset of an epidemic in children. preschool institutions and schools. In the case of adults, the process of transmission of the virus proceeds somewhat differently. To non-observance of personal hygiene, as the main reason for the onset of the development of the disease, there are added HIV infections and promiscuous sex life in a person, since in middle-aged and older people the virus enters the body precisely during intercourse.

What happens when you get infected with molluscum contagiosum?

The elementary bodies of the mollusk penetrate into the surface layers of the skin, after which they increase in size, form increasingly large-scale colonies and gradually move to healthy areas of the skin. Clusters of pathogens in the affected area look like nodules filled with a granular mass. Conglomerates of molluscs are up to 2-3 cm in diameter and are located in groups. When a molluscum contagiosum is diagnosed, treatment should begin as soon as possible. This is due to the fact that slowly but surely the colonies of pathogens spread throughout the skin.

Symptoms and course of molluscum contagiosum

The incubation period for the virus ranges from 2 weeks to several months. The timing of the onset of symptoms of molluscum contagiosum depends on the patient's age and general condition his body.

One of the most characteristic symptoms molluscum contagiosum are skin rashes. They look like single and multiple nodules of an oval or hemispherical shape. The nodules do not hurt, they have the color of the normal skin. Often they shine, much less often they are surrounded by an inflammatory rim. Even less often, molluscum contagiosum in children affects not only the skin, but also the mucous membranes.

Molluscum contagiosum can progress over several years, but this is an extreme scenario. In most cases, the nodules disappear on their own within six months. At the same time, any specific removal of molluscum contagiosum is usually not required, but experts still resort to some procedures in order to accelerate the destruction of the pathogens of the virus.

We also note that nodules - clusters of pathogens have a characteristic appearance, do not at all look like warts or any other skin diseases and therefore are easily diagnosed with a detailed examination of the patient. True, they can be confused with benign formations, but this is already a matter of the competence of the specialist who will conduct the examination.

Molluscum contagiosum - treatment of the disease

All measures to remove pathogens of molluscum contagiosum are reduced to gentle opening of the nodules and subsequent lubrication of the wound with an alcohol solution of iodine. To speed up the process, the removal of molluscum contagiosum is performed using cold (liquid nitrogen), electric current (diathermocoangulation) or surgical intervention (scraping the content with special tools). In the event that doctors diagnose an extensive molluscum contagiosum in children and a large area of \u200b\u200bskin lesions, the patients are prescribed ultraviolet irradiation and antiviral ointments... The body's defenses are strengthened by the appointment of general strengthening procedures.

Do not self-medicate for any disease. Contagious molluscum was no exception to the rule. As we said above, nodules can be easily confused with benign tumors... Accordingly, squeezing out the formations without consulting a doctor, you can injure a hitherto harmless formation, which will then turn into a malignant form.

For a quick and painless recovery, it will be useful to decontaminate children's clothes, baby's personal hygiene items and toys. Adult patients are advised to give up sexual intercourse until the end of treatment, since if quarantine measures are not followed, the pathogen can enter the body of the partner of an infected person.

Prevention of molluscum contagiosum

Prevention of molluscum contagiosum consists in the timely detection of infection and adherence to the rules of personal hygiene. In addition, the activation of the body's defenses, strengthening the immune system is of great importance. The child needs to be tempered, do not forget about gymnastics, water treatments, physical exercise and outdoor games.

Molluscum contagiosum is a dermatologic lesion skin infectious etiology, characterized by the formation of medium-sized nodules with a characteristic depression and a white or pinkish color.

The immediate causative agent of the disease are pathogenic microorganisms classified as poxviruses. Dermatological lesions on the skin and mucous membranes are benign neoplasms, and do not have a tendency to develop inflammatory processes.

However, a long course of the disease against the background of the lack of adequate therapy can lead to the addition of a secondary infection. Due to the massive number of pathways of invasion and the high level of infectiousness, the disease is widespread and is diagnosed in both adults and children.

Classification of the disease according to ICD 10

In the field of medicine, a special international classification has been developed, through which the level of morbidity and mortality of the population is recorded. According to its main provisions, each pathology is assigned a certain code consisting of alphabetic and numerical values. Molluscum contagiosum was assigned the ICD code 10 B08.1.

Ways of transmission

As mentioned above, the direct causative agent of an infectious disease is one of the members of the poxvius family. A characteristic feature of the disease is called high level infectiousness. Numerous factors can cause the invasion, including the following:

• parenteral route of infection. Occurs through contact with an infected person, as well as his body fluids. Infection can occur even with a handshake. In the adult population, an intimate route of infection is characteristic and common, for example, from a man's sexual partner to a woman.
• Domestic. You can become infected with molluscum contagiosum when visiting public places, when using other people's personal hygiene items, household items, and household items. Children can catch the infection when playing with other people's toys or, for example, when playing in a sandbox.
• Vertical. Infection by the mother of the child during natural childbirth It is also possible, however, it should be noted that in practice this happens more often in the presence of lesions of the skin and mucous membranes in the genital area.

Thus, you can get infected with molluscum contagiosum almost everywhere. Long time the virus can be in the blood in a dormant, that is, a latent state, without showing itself in any way. Factors such as a decrease in immune forces, the presence of HIV infection, less severe chronic ailments, hormonal imbalances, and an overly strict diet can lead to the stimulation of the activity of the viral flora.

The psychosomatics of molluscum contagiosum also plays an important role. Factors such as depression, stress, and nervous tension can cause a surge in the activity of the viral flora. The lack of sufficient sleep can also significantly reduce the body's resistance, make it more susceptible to the action of pathogenic flora.

Forms and types

For molluscum contagiosum, which is assigned a code according to ICD 10 B0.1, a subdivision into certain species is characteristic, which may have significant differences. The main forms are:

• gigantic. The dimensions of these growths are from 2 centimeters. The formation of such large nodes is due to the merger of several small ones.
• Miliary. It is characterized by the appearance of a large number of small growths located in close proximity to each other.
• Cystic. Entities can have different shape, however, the determining factor in this case is the absence of a characteristic depression in the center of the molluscum contagiosum node.
• Keratinizing. It is observed only if the patient has excessively dry or sensitive skin. The surface of the nodes in such cases is covered with a whitish coating or a thin dry film.
• Ulcerated. For this form, the addition of a secondary infection and the development of inflammatory processes are characteristic. This form is characterized by the formation of large scars.

For the appointment of the most suitable therapy, it is required to determine the form of molluscum contagiosum.

Video

Molluscum contagiosum

Symptoms

In order to timely identify the disease, it is important to know how they look clinical manifestations molluscum contagiosum. In the field of dermatovenerology, there are several characteristic symptoms inherent in this infectious disease. The main ones are the following:

• the formation of nodules can be observed in the upper abdomen, on the face, eyelids, neck, in the intimate area, on the thighs. The specificity of the appearance of foci of infection depends on the area of \u200b\u200bintroduction of the virus into the body.
• At the initial stages of invasion, papules are dense oval neoplasms that become softer over time. In the center of the growth there is a characteristic dimple or depression.
• The growths with molluscum contagiosum do not lead to soreness, but they may well itch and itch. It is very important to follow the rules of personal hygiene, since when combing papules, there is a high probability of attaching a secondary infection, development inflammatory process.
• When pressed on the papule, a white rather dense mass is released, which can have a curdled consistency and a rather unpleasant odor.

In the early stages of invasion, papules or nodes of molluscum contagiosum may be small in size, practically not protruding above the surface of the skin. It is during this period that the disease is especially amenable to the treatment used.

Diagnostics

To diagnose molluscum contagiosum, a detailed examination of the papules or nodes under a microscope is required. As a rule, the use of additional research options is not required. In some cases, for example, if there is suspicion of other diseases, it may be necessary differential diagnosis, allowing to exclude other pathologies of infectious etiology.

Is pathology contagious

Molluscum contagiosum virus or VKM is highly contagious. Infection can occur through contact with an infected person, household items, and when visiting public places. The incubation period of molluscum contagiosum can last from several weeks to several months, this aspect depends on the level of resistance of the patient's body. Thus, the question of whether molluscum contagiosum is contagious or not can be answered exclusively in the affirmative.

Treatment methods

In case of infection with molluscum contagiosum, it is recommended to start treatment as early as possible, this will help prevent possible complications, as well as choose the most suitable and most gentle method that will help eliminate the infection. Traditional treatments for molluscum contagiosum are as follows:

• application antiviral agentsintended for oral administration.
• The use of medicines for external use.
• Involvement of invasive treatment methods, which are especially often used in the presence of large growths.

To eliminate nodes on the skin and mucous tissues, medicationswith antiviral and antiseptic properties. Most often, these include: acyclovir ointment, oxolinic ointment, viferon.

To completely remove the manifestations of molluscum contagiosum, it is required to apply the selected agent at least four times a day.

The use of antiseptic and disinfectants is also recommended. medicines, the main ones among which are the following: fucorcin, alcohol solution iodine, alcohol solution boric acid... It is permissible to use the listed preparations only for treating the skin. It is strongly not recommended to treat mucous membranes with them, as this can lead to burns.

After removal of the nodes of molluscum contagiosum, visible scars may remain on the skin. To prevent this, experts recommend using invasive treatment methods that will help completely remove growths and prevent the appearance of scars:

• ultrasound therapy. This view treatment is among the most innovative and gentle. Its use allows you to completely eliminate the appearance of scars and eliminate pathogenic growths. The method is practically painless, however, if necessary, it is possible to use anesthetics.
• Laser therapy. Laser therapy also removes growths and prevents scars. One session is enough to remove even large nodes. Re-formation of growths is excluded.
• Electrocoagulation.
• Cryodestruction. Skin exposure to liquid nitrogen. It may take several sessions to remove large growths. The method is especially painful, and therefore necessary application anesthetic drugs.

In addition to the above drugs and methods, it is also recommended to take measures aimed at increasing the immune forces, the body's resistance, this will help to cope with the disease many times faster.

Molluscum contagiosum is a skin disease (ICD-10 code - B08. 1, Molluscum contagiosum) caused by a DNA-containing virus belonging to the poxivirus group.

The smallpox virus belongs to this group. The disease affects only humans.

It manifests itself in the fact that on the surface layers of the skin (less often on the mucous membranes) hemispherical nodules are formed, sometimes on a leg, ranging in size from a pinhead to a pea. They protrude slightly above the skin level.

Most often, the size of the nodules is 0.3-0.5 cm. Outwardly, they look like papillomas.

In the center benign education there is an umbilical depression.

There are 4 types of this virus, of which two are most common:

• I-MCV, occurring in 75% of patients;
• II-MCV, sexually transmitted infection in adults.

The disease is more likely to affect children aged 1-4 years than adults. Epidemic outbreaks are observed in children's groups. Salient features rashes are the following symptoms:

• when the subcutaneous formation is opened, a crumb-like curd mass (mollusk body) comes out onto the surface, which contains keratinized cells and viral mollusc-like particles;
• the color of the papules is the same as that of the skin, or a slightly more pink tint;
• lack of pain;
• on initial stage - a small number of papules;
• mild itching at the stage of maturation;
• the presence of a depression in the center of the skin formation.

The rash can become inflamed if bacterial contamination occurs. Then painful sores containing pus form on the skin. This form of the disease is common in HIV-infected people, where papules can cover large areas of the skin.

On average, after 2-3 months, an acquired immunity to the virus develops in a person affected by molluscum contagiosum, but it is unstable and especially weak in elderly people.

Most often, rashes appear on the following body surfaces:

• hands;
• inner surfaces of the shoulders and forearms;
• legs and buttocks;
• face;
• the front surface of the abdomen;
• neck and chest;
• anus area.

In adults, during sexual transmission of the virus, a rash appears on the genitals (the shaft of the penis in men, the labia majora in women), in the lower abdomen, on the pubis and inner thighs.

The disease itself is harmless, but it can cause three complications:

• dermatitis (with the addition of a bacterial infection);
• the formation of large foci of skin lesions when nodules merge. This complication is observed in patients with a pronounced decrease in the body's defenses;
• conjunctivitis as a result of lesions of the eyelids.

The diagnosis of the disease is most often established visually. In some cases, microscopic examination of the contents of the papule is performed.

Molluscum contagiosum is a widespread benign skin lesion. Characterized by the formation of small papules with an impression in the center, pearly white, pink or normal skin color, located in children on the face, trunk, extremities, in adults - in the groin and genitals.

The reasons for the appearance and the mechanism of development

The disease is caused by an orthopoxvirus, which belongs to the Poxviridae family, the Chordopoxviridae subfamily, the Molluscipoxvirus genus. There are 4 types of molluscum contagiosum virus: MCV-1, MCV-2, MCV-3, MCV-4.

The most common type is MCV-1; type MCV-2 is usually detected in adults and is sexually transmitted. Orthopoxvirus belongs to DNA-containing viruses, is not cultivated in the tissues of chicken embryos and is not pathogenic for laboratory animals.

Most often, the virus attacks children from 1 year to 12-15 years. At risk are young patients with unsatisfactory sanitary conditions living and problems with immune system... It is noteworthy that babies under one year old rarely get sick. In their body, the mother's antibodies are still present, which successfully resist the pathogen.

3 Causes of the onset of the disease

The factors that trigger the appearance of a rash are the following:

• decreased immunity under the influence of adverse environmental factors and diseases;
• treatment with corticosteroid drugs and cytostatics;
• mechanical impact and damage to the skin (combing, scratching, shaving, squeezing).

To completely eliminate the rash, it is necessary to deal with its main cause - the weakening of the protective functions of the body.

Etiology

The causative agent is an unclassified virus of the Chordopoxvirus subfamily of the Poxviridae family.

Epidemiology

1.3 Epidemiology

The prevalence of the disease in various countries ranges from 1.2% to 22% of the population. The disease is ubiquitous and affects a person at any age.

Infection occurs through direct contact with a sick person or a virus carrier, or indirectly through personal and household items. The incubation period of the disease varies from 1 week to several months, with an average of 2 to 7 weeks.

The disease is more often detected in children aged 1 to 4 years. In older children, infection usually occurs when they visit the swimming pool or engage in contact sports.

Children with eczema or atopic dermatitisreceiving treatment with glucocorticosteroid drugs. In young people, infection with molluscum contagiosum often occurs through sexual contact.

In middle-aged and elderly people, long-term use of glucocorticosteroid drugs and cytostatics can be a provoking factor in the development of the disease. In HIV-infected patients, due to the immunodeficiency state of the body, there is an increased tendency to the appearance of molluscum contagiosum, characterized by a recurrent course.

1.6 Clinical picture

Elements of molluscum contagiosum can be located on any part of the skin.

In children, formations are more often localized on the skin of the face (more often on the eyelids and forehead), neck, upper half of the chest (especially in the armpits), upper limbs (rear of the hands); in adults - on the skin of the lower abdomen, pubis, inner thighs, the skin of the external genitalia, around the anus.

The defeat of the eyelids may be accompanied by conjunctivitis. Have HIV-infected persons lesions are most often localized on the skin of the face, neck and trunk.

Elements of molluscum contagiosum are nodules 0.1-0.2 cm in size, hemispherical or slightly flattened, dense, painless, normal skin color or pale pink, often with a waxy sheen, with an umbilical depression in the center.

The nodules rapidly increase in size up to 0.5-0.7 cm, are located in isolation on unchanged skin, less often they are surrounded by a weakly pronounced inflammatory rim. When the nodules are squeezed from the sides, a white, crumbly (mushy) mass is released from the central hole, consisting of degenerative epithelial cells with large protoplasmic inclusions.

Molluscum contagiosum is a benign viral skin disease characterized by the appearance on the skin, less often on the mucous membranes of hemispherical nodules ranging in size from a pinhead to a pea with a central umbilical depression.

Etiology and epidemiology of molluscum contagiosum

The disease is caused by an orthopoxvirus, which belongs to the Poxviridae family, the Chordopoxviridae subfamily, the Molluscipoxvirus genus. There are 4 types of molluscum contagiosum virus: MCV-1, MCV-2, MCV-3, MCV-4. The most common type is MCV-1; type MCV-2 is usually detected in adults and is sexually transmitted. Orthopoxvirus belongs to DNA-containing viruses, is not cultivated in the tissues of chicken embryos and is not pathogenic for laboratory animals. The disease is ubiquitous and affects a person at any age.

Infection occurs through direct contact with a patient or a virus carrier, or indirectly - through personal and household items. The incubation period of the disease varies from 1 week to several months, with an average of 2 to 7 weeks.

The disease is more often detected in children aged 1 to 4 years. In older children, infection usually occurs when they visit the swimming pool or engage in contact sports. More often children suffering from eczema or atopic dermatitis, receiving treatment with glucocorticosteroid drugs, are ill.
In young people, infection with molluscum contagiosum often occurs through sexual contact.

In middle-aged and elderly people, long-term use of glucocorticosteroid drugs and cytostatics can be a provoking factor in the development of the disease.

In HIV-infected patients, due to the immunodeficiency state of the body, there is an increased tendency to the appearance of molluscum contagiosum, characterized by a recurrent course.

The prevalence of the disease in various countries ranges from 1.2% to 22% of the population.

Classification of molluscum contagiosum

Absent.

Molluscum Contagiosum Symptoms

Elements of molluscum contagiosum can be located on any part of the skin.
In children, formations are more often localized on the skin of the face (more often on the eyelids and forehead), neck, upper half of the chest (especially in the armpits), upper limbs (rear of the hands); in adults - on the skin of the lower abdomen, pubis, inner thighs, the skin of the external genitalia, around the anus. The defeat of the eyelids may be accompanied by conjunctivitis. In HIV-infected persons, the lesions are most often localized on the skin of the face, neck and trunk.

Elements of molluscum contagiosum are nodules 0.1–0.2 cm in size, hemispherical or slightly flattened, dense, painless, normal skin color or pale pink, often with a waxy sheen, with an umbilical depression in the center. The nodules rapidly increase in size up to 0.5–0.7 cm, are located in isolation on unchanged skin, less often surrounded by a weakly expressed inflammatory rim. When the nodules are squeezed from the sides, a white, crumbly (mushy) mass is released from the central hole, consisting of degenerative epithelial cells with large protoplasmic inclusions. The number of elements of the rash is different: from 5-10 to several dozen or more.

In the vast majority of cases, rashes are not accompanied by subjective sensations and are only a cosmetic problem for the patient. Usually the disease is self-limiting and morphological elements, even without treatment, can disappear spontaneously after a few months. However, children have a long course of molluscum contagiosum (from 6 months to 5 years), as a result of autoinoculation of the causative agent of the disease

Atypical forms of molluscum contagiosum include:

• giant molluscs (3cm or more in diameter);

• cystic molluscs;

Diagnosis of molluscum contagiosum

The diagnosis of molluscum contagiosum is based on clinical data, but in some cases (atypical clinical picture) microscopic and / or pathomorphological examination of skin biopsies is necessary.
Microscopic examination of the contents of nodules with staining according to Romanovsky-Giemsa, Gram, Wright or Papanicolaou reveals large brick-shaped intracellular inclusions of viral bodies.

With pathomorphological examination, proliferative and degenerative changes cells of the prickly layer. The nodule formed due to the proliferation of the epidermis is divided by radial connective tissue septa into a series of pear-shaped lobules. In the upper sections of the lobules, the cells of the epidermis contain large eosinophilic inclusions - mollusk bodies. The cytoplasm of the cells of the spinous layer is vacuolated and homogenized. The cells of the basal layer are not affected. Inflammatory changes in the dermis are minor or absent. With long-term elements in the dermis, there may be a chronic granulomatous infiltrate.

Differential diagnosis of molluscum contagiosum

The disease is differentiated from flat warts, which are observed in adolescents and young people. Flat warts are usually multiple, located on the face and back of the hands. They look like small, rounded papules with a smooth surface, the color of normal skin.

Vulgar warts are often located on the back of the hands, represent a dense papule with an uneven, rough or papillary surface covered with hyperkeratotic masses. There is no central depression and no pearlescent color.

Keratoacanthomas are more often observed in persons over the age of 50 on open areas of the skin in the form of a single hemispherical formation of normal or pale reddish color. In the center of the formations, there are small crater-shaped depressions filled with horny masses, which are easily removed and are not accompanied by bleeding.

Milium is detected in newborns, infants and early age; can disappear spontaneously. Rashes are often localized in the cheeks, under the eyes. There are single or multiple miliary nodules, dense, whitish or whitish-yellow in color.

Acne occurs against the background of seborrhea, is located on the face, back and chest. The rashes are presented by inflammatory papules of a conical or hemispherical shape, soft consistency, pink or bluish-red.

Treatment of molluscum contagiosum

Treatment goals:

• regression of rashes;
• no relapses.

General notes on therapy

The main direction of therapy is the destruction of the elements of molluscum contagiosum. Taking into account the possibility of autoinoculation, it is necessary to remove all elements of the molluscum contagiosum, for which, before the therapy, the entire surface of the patient's skin should be examined, paying attention to the folds of the skin. Patients should be advised not to shave areas of skin with rashes, as this can lead to autoinoculation.

Indications for hospitalization

Absent

Molluscum contagiosum removal methods:

• Curettage - mechanical removal of lesions with a curette. The procedure is painful. After curettage, small, slightly sinking scars may develop. Failures of curettage therapy can be caused by a large number of rashes and concomitant dermatological pathology (atopic dermatitis).
• Cryotherapy: each element of the molluscum contagiosum is exposed to liquid nitrogen for 6–20 seconds. If the rash persists, the procedure is repeated after a week. The cryotherapy procedure is accompanied by soreness and blistering, after which there may be a violation of skin pigmentation, the formation of mild scars.
• Evisceration (peeling) is carried out with fine tweezers and is recommended for removing fresh rashes. This method allows you to obtain material for the subsequent pathohistological verification of the diagnosis.
• Laser therapy: elements of molluscum contagiosum CO 2 laser or pulsed dye laser with characteristics: wavelength 585 nm, frequency 0.5-1 Hertz, spot size 3-7 mm, energy density 2-8 J / cm 2, pulse duration - 250-450 ms (D). If, after the laser therapy procedure, the rash persists, the repeated destruction is carried out in 2-3 weeks.
• Electrocoagulation of molluscum contagiosum elements.

To reduce pain and discomfort during the destruction of molluscum contagiosum elements, local anesthesia is used.

After the destruction of the elements of molluscum contagiosum, the areas of the skin on which they were located are treated with antiseptics: iodine + [potassium iodide + ethanol], 5% alcohol solution.

Special situations

Patients with atopic dermatitis have a high risk of scar formation with a large number of rashes, and therefore curettage is undesirable. Before starting therapy for molluscum contagiosum, it is recommended to treat exacerbation of atopic dermatitis.

In cases where molluscum contagiosum rashes are detected in patients with impaired immunity, it is necessary to avoid treatment methods associated with a violation of the integrity of the skin, since these patients have a high risk of developing infectious complications. Cases of regression of molluscum contagiosum eruptions after initiation of antiretroviral therapy have been reported.

During pregnancy, the use of all methods of destruction is allowed.

Requirements for treatment results

• resolution of rashes;
• complete clinical remission.

Prevention of molluscum contagiosum

Preventive measures include: isolating sick children from the team until complete recovery and observing the rules of personal and public hygiene. For the period of treatment, it is prohibited to visit swimming pools, gyms, public baths.

Measures for the prevention of molluscum contagiosum also include preventive examinations of children in preschool institutions and schools, early detection of cases of molluscum contagiosum, timely treatment of patients and their sexual partners.

A patient with molluscum contagiosum, until the end of treatment, should only use his personal belongings and utensils, avoid sexual and close physical contact, and do not visit the pool or sauna.

In young people, molluscum contagiosum is transmitted primarily sexually, and therefore it is recommended to examine the sexual partners.

IF YOU HAVE ANY QUESTIONS ABOUT THIS DISEASE, PLEASE CONTACT DOCTOR DERMATOVENEROLOGY Kh.M. ADAEV:

WHATSAPP 8 989 933 87 34

EMAIL: [email protected]

INSTAGRAM @ DERMATOLOG_95