Molluscum contagiosum
| Classification according to ICD-10 | |
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| B08.1 | Molluscum contagiosum |
| ICD-10 online (WHO version 2019) | |
Molluscum contagiosum ( synonyms pelvis , Epithelioma molluscum , Epithelioma contagiosum , mollusc ) describes a nodular skin appearance ( efflorescence ), which is caused by a virus infection. The transmission from person to person occurs through direct contact (also sexual). The course of this common infectious disease is in most cases benign and self-limiting, they usually resolve completely in the course of up to 18 months. Children (especially those with atopic eczema ), sexually active adults, and the immunosuppressed are most commonly affected .
Appearance and cause
Dellar warts are on average 2–6 mm in size, white, reddish or skin-colored nodules with a smooth and often shiny surface that always appear multiple. They usually have a dent in the middle, which can have a small opening, and occur in different numbers (a few to several hundred molluscs) all over the body, especially on the arms, hands, fingers, genitals and upper body. In adults, it is predominant in the genital area. Pressure on warts leads to the emptying of a creamy to doughy mass, which is also called molluscum pulp or molluscum bodies. Dell warts are particularly common in children, especially in children with atopic eczema ( neurodermatitis ), in people with immunodeficiency, people on cortisone therapy and sexually active adults.
Occasionally, local inflammation or eczema can develop in the vicinity of the warts .
Pathogen
| Molluscum contagiosum virus | ||||||||||||||||||||
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The molluscum contagiosum virus ( TEM image) |
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| Molluscum contagiosum virus | ||||||||||||||||||||
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| MOCV / MCV | ||||||||||||||||||||
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Contrary to the most common German names, mollusks are not counted among the warts (Verruccae). They arise after infection by the Molluscum contagiosum virus (MOCV or MCV), the type species from the genus Molluscipoxvirus in the subfamily Chordopoxvirinae of the smallpox viruses . It is enveloped, double-stranded DNA - viruses ( dsDNA viruses ).
The genome of the virus of subtype 1 is 190,289 base pairs (bp) in length. It encodes a predicted 163 proteins , the GC content is 63%.
transmission
The transmission occurs in humans through smear infection or contact infection , mostly within a household, but also in swimming pools and kindergartens through the shared use of towels. If a family member is affected, the infectious disease usually spreads to other members within a few months, with pre-school and primary school children being the most vulnerable. An estimated 2–8% of the world's population are infected with the virus, with areas of high population density, poor hygiene and poverty being more severely affected. A first peak of the disease is observed in childhood, a second in early adulthood - here also as a sexually transmitted disease . The incubation period is very variable and is between 2 weeks and 6 months.
diagnosis
Thanks to the characteristic appearance, a visual diagnosis is usually possible. In cases of doubt, a histopathological examination can confirm the diagnosis.
therapy
In a large proportion of patients, the changes resolve spontaneously after six to 18 months without treatment. But they can also last for several years. Mollusca contagiosa grows very slowly.
If necessary, dellar warts can be surgically removed by removing them with a sharp spoon or another sharp instrument under local anesthesia. The cryotherapy (freezing) is a possible alternative, as well as the therapy with the pulsed dye laser . Drug treatment is also possible. Therapy with 5% potassium hydroxide solution has proven itself (Jansen et al. 2007).
literature
- D. Hanson, DG Divas: Molluscum contagiosum. In: Dermatology online journal. Volume 9, Number 2, March 2003, p. 2, ISSN 1087-2108 . PMID 12639455 .
- T. Jansen, R. Romiti, J. Dissemond, S. Grabbe: Evaluation of the effectiveness and tolerability of 5% potassium hydroxide solution in the treatment of Mollsucum contagiosum in childhood. In: Current Dermatology Edition 6, 2007, pp. 210–215, doi: 10.1055 / s-2007-966517
Web links
Individual evidence
- ^ Information sheet Dellwarzen. (PDF; 43 kB) (No longer available online.) State Capital Kiel, Office for Health, October 2006, archived from the original on September 3, 2013 ; accessed on May 10, 2018 .
- ↑ a b c d e ICTV: ICTV Taxonomy history: Variola virus , EC 51, Berlin, Germany, July 2019; Email ratification March 2020 (MSL # 35)
- ↑ David M. Needham, Alexandra Z. Worden et al .: A distinct lineage of giant viruses brings a rhodopsin photosystem to unicellular marine predators , in: PNAS, 23 September 2019, doi: 10.1073 / pnas.1907517116 , ISSN 0027-8424 , here: Supplement 1 (xlsx)
