Recombination events and variability among full-length genomes of co-circulating molluscum contagiosum virus subtypes 1 and 2.

Molluscum contagiosum virus (MCV) is the sole member of the Molluscipoxvirus genus and causes a highly prevalent human disease of the skin characterized by the formation of a variable number of lesions that can persist for prolonged periods of time. Two major genotypes, subtype 1 and subtype 2, are recognized, although currently only a single complete genomic sequence corresponding to MCV subtype 1 is available. Using next-generation sequencing techniques, we report the complete genomic sequence of four new MCV isolates, including the first one derived from a subtype 2. Comparisons suggest a relatively distant evolutionary split between both MCV subtypes. Further, our data illustrate concurrent circulation of distinct viruses within a population and reveal the existence of recombination events among them. These results help identify a set of MCV genes with potentially relevant roles in molluscum contagiosum epidemiology and pathogenesis.

An update on the clinical management of cutaneous molluscum contagiosum.

Molluscum contagiosum is a poxvirus infection of the skin that is commonly observed in children. The molluscum contagiosum virus (MCV) expresses several gene-products that are involved in its pathogenesis and evasion of the host immune system. MCV can be transmitted both to other sites of the body and to other individuals through direct physical contact as well as fomites. While diagnosis is generally straightforward clinically, management of molluscum contagiosum is controversial. Several treatment options are available for the destruction of individual lesions, but there is insufficient evidence for therapeutic intervention being any more effective than natural, spontaneous resolution. Complex cases, such as infection occurring in immunocompromised patients and in mucocutaneous sites, require an alternative approach to management. Molluscum contagiosum continues to represent a burden on children and parents worldwide.

Prevalence of Common Viral Skin Infections in Beach Volleyball Athletes.

Viral skin infections often affect the sports community. The aim of this study was to assess the rates, location sites, and seasons of appearance of common viral cutaneous diseases in beach volleyball athletes in Greece. Five hundred and forty-nine beach volleyball athletes participated in this study. The average age was 28.4 years. The viral infections were herpes simplex (type 1), molluscum contagiosum and warts. The measured parameters included: gender, age, the season when athletes may be more susceptible to infections and the location of infection in the body. Practicing information such as the number of training years, number of weekly trainings, and average hours of daily training was also recorded. Incidence rates correlated in relation to age: (a) warts (p < 0.001), molluscum contagiosum (p < 0.001), and herpes simplex (p = 0.001); (b) years of training: warts (p < 0.001), molluscum contagiosum (p < 0.001), and herpes simplex (p = 0.004); (c) average hours of daily training: molluscum contagiosum (p = 0.006) and herpes simplex (p < 0.010). The skin is the largest organ, and the risk of infection should not be underestimated. Prevention, early detection, recognition, and treatment are related to health and athletic performance, but also to the risk of transmission.

Pediatric molluscum contagiosum: reflections on the last challenging poxvirus infection, Part 1.

Molluscum contagiosum (MC) is a common dermatologic infection that usually affects school-aged children, sexually active young adults, and immunocompromised individuals. It is a benign and self-limiting disease, with most cases undergoing spontaneous resolution within 6 to 9 months. However, a more severe and prolonged course is associated with immunosuppression or atopic dermatitis (AD). Management can be challenging; it needs to be decided whether to treat MC or let it run its natural course. It may be managed with reassurance and benign neglect; however, therapeutic intervention may be indicated to prevent autoinoculation and transmission, especially in patients at risk for severe disease. Guardians concerned about cosmesis should understand that therapy may leave pigmentary alterations and sometimes scars. The 3 major therapeutic modalities employed are physical destruction, immunomodulation, and antiviral agents. Combinations of these therapies may be employed. Therapeutic modalities will be discussed in part 2.

Pediatric molluscum contagiosum: reflections on the last challenging poxvirus infection, Part 2.

Molluscum contagiosum (MC) is a common dermatologic infection that usually affects school-aged children, sexually active young adults, and immunocompromised individuals. It is a benign and self-limiting disease, with most cases undergoing spontaneous resolution within 6 to 9 months. However, a more severe and prolonged course is associated with immunosuppression or atopic dermatitis. Treatment is recommended because of the high rate of associated symptoms, risk for transmissibility, and cosmetic or social concerns. Therapeutic modalities are subdivided into 3 types: destructive, immunomodulatory, and antiviral. We review the advantages and disadvantages of various agents and discuss combination therapy.

Atypical presentation of genital molluscum contagiosum mimicking genital warts.

A man in his 20s with a history of unprotected sex with a commercial sex worker three months before presented with a solitary slowly-growing, well-defined, non-tender, oval, verrucous lesion on the mucosal aspect of his prepuce. Dermoscopy revealed a polylobular, pinkish-white, amorphous structure in the centre with a surrounding crown of vessels that did not cross the centre of the lobules, and histopathology showed keratinocytes containing intracytoplasmic faintly granular eosinophilic inclusions and peripherally-pushed nuclei. A diagnosis of agminated genital molluscum contagiosum was reached on the basis of the above findings. Molluscum contagiosum can present with several atypical morphologies mimicking other dermatoses. Agminated molluscum contagiosum can closely mimic a genital wart especially if it is involving the ano-genital region. Awareness among clinicians regarding the atypical presentations of molluscum contagiosum is imperative for early diagnosis and management of this infectious condition.

Molluscum contagiosum virus infection can trigger atopic dermatitis disease onset or flare.

Predisposition to cutaneous viral infections is known to be a minor criterion of Hanifin and Rajka's diagnostic standard of atopic dermatitis (AD); however, the causal relationship between molluscum contagiosum virus (MCV) infection and AD onset or aggravation has not been widely explored. The objective of this study was to identify pediatric patients with AD onset or flare triggered by MCV infection as well as to characterize the setting under which MCV may trigger AD onset or flares in children. Fifty children with prior or current MCV infection presenting sequentially to an outpatient pediatric dermatology practice over a 1-month period were evaluated. Results indicated that children who contract MCV infection may be targets for skin care interventions to prevent and/or control AD.

Periocular molluscum contagiosum: six different clinical presentations.

PURPOSE: To describe the different clinical presentations of periocular molluscum contagiosum (MC) lesions and their epidemiological, clinical and histopathological features. METHODS: Medical records and histopathological sections of all cases of periocular MC treated at the oculoplastic clinic of the Goldschleger Eye Institute, Sheba Medical Center, Israel, between 1995 and 2016 were retrospectively reviewed. The following data were extracted: gender, age at the time of MC diagnosis, immune competency, location of the periocular lesions, number of lesions, dimensions of the lesions, clinical presentation, histopathological features, suspected clinical diagnosis before histopathological diagnosis and treatment. RESULTS: The series was composed of 41 patients (19 males, 22 females) whose mean age at presentation was 20.41 â€Š± â€Š21.10 years (range 1-71 years). Only one patient was immunosuppressed. The cases were classified into six proposed clinical presentations: 'umbilicated nodular', 'big/giant', 'conglomerated', 'erythematous', 'inflamed' and 'pedunculated'. CONCLUSION: This is the first time that different clinical types of MC lesions are labelled. The current evidence also indicates that MC lesions should be suspected not only in children and in immunosuppressed adult patients but also in immunocompetent patients of all ages.

Identification and genotyping of molluscum contagiosum virus from genital swab samples by real-time PCR and Pyrosequencing.

BACKGROUND: Laboratory diagnosis of molluscum contagiosum virus (MCV) is important as lesions can be confused with those caused by Cryptococcus neoformans, herpes simplex virus, human papillomavirus, and varicella-zoster virus. OBJECTIVES: To develop a rapid method for identifying patients infected with MCV via swab sampling. STUDY DESIGN: Two dual-labeled probe real-time PCR assays, one homologous to the p43K gene and one to the MC080R gene, were designed. The p43K PCR was designed to be used in conjunction with Pyrosequencing for confirmation of PCR products and discrimination between MCV1 and MCV2. RESULTS: Both PCR assays were optimized with respect to reaction components, thermocycling parameters, and primer and probe concentrations. The specificities of both PCR assays were confirmed by non-amplification of 38 known human pathogens. Sensitivity assays demonstrated detection of as few as 10 copies per reaction. Testing 703 swabs, concordance between the two real-time PCR assays was 99.9%. Under the developed conditions, Pyrosequencing of the p43K PCR product was capable of providing enough nucleotide sequence to definitively differentiate MCV1 and MCV2. CONCLUSIONS: These real-time PCR assays can be used for the rapid, sensitive, and specific detection of MCV and, when combined with Pyrosequencing, can further discriminate between MCV1 and MCV2.

Efficacy of pulsed dyed laser (585 nm) in the treatment of molluscum contagiosum subtype 1.

Molluscum contagiosum is a common cutaneous disease that may be difficult to treat when there are multiple lesions; especially in children. This study was conducted to determine the efficacy of pulsed dye laser (585 nm) in the treatment of molluscum contagiosum in 20 children. In the treated group, 70.5% of lesions healed after the first treatment; the remaining 10.6% after the second treatment (2 weeks later). The overall cure rate was significantly different from the control group (p< 0.01). The therapy was also well tolerated. Only mild transient hypopigmentation and erythema were observed. None encountered infectious events. In conclusion, pulsed dye laser is a good alternative treatment for molluscum contagiosum due to high efficacy and mild transient side effects.

Vascular network tightly enclosing lesions of molluscum contagiosum: Basket-like capillaries of molluscum.

Immunohistochemical studies of one typical and two atypical cases of molluscum contagiosum with anti-CD34 monoclonal antibodies showed a tightly enclosing fine vasculature around the lesional masses of the disease. The thin interstitial septa between the lobules of the molluscum lesions also contained abundant endothelium. An electron microscopic study of a pinched-off lesion of common molluscum contagiosum demonstrated that the tightly enclosing blood vessels lacked muscle layers, suggesting that they were capillaries, being a distance of several hundred nanometers from the basal cells of the molluscum mass. A 3D constructed image of the vasculature confirmed a network of the vessels. These tightly enclosing vascular networks around the lesions of molluscum contagiosum support the rapid growth of this disease.