Molluscum Contagiosum

传染性软疣
  • 文章类型: Case Reports
    传染性软疣(MC)是儿童常见的病毒感染,会影响皮肤和口腔粘膜。它是由传染性软体动物病毒(MCV)引起的,痘病毒科中的一种双链DNA病毒。通过皮肤直接接触进行传输,自我接种,和接触受污染的物体。临床上,它的特征是存在单个或多个扩大的圆顶形或甜甜圈形的肉色丘疹,具有中央脐状,通常称为“软体动物”。MC的诊断主要基于临床观察,除了组织病理学检查以揭示特征软体动物的身体,也被称为亨德森-帕特森尸体。目前的治疗方法包括机械,化学,免疫调节,和抗病毒治疗。在这种情况下,我们提出一例42岁男性感染MC,概述了临床和组织病理学发现。
    Molluscum contagiosum (MC) is a common viral infection in children that affects the skin and oral mucous membranes. It is caused by the molluscum contagiosum virus (MCV), a double-stranded DNA virus in the Poxviridae family. Transmission takes place via direct skin contact, self-inoculation, and exposure to contaminated objects. Clinically, it is characterized by the presence of a single or multiple enlarged dome-shaped or doughnut-shaped flesh-colored papules with central umbilication, usually called \"mollusca\". The diagnosis of MC is based mainly on clinical observations, in addition to histopathological examinations to reveal characteristic molluscum bodies, also known as Henderson-Patterson bodies. Current treatment methods include mechanical, chemical, immune modulation, and antiviral treatments. In this context, we present a case involving a 42-year-old male infected with MC, outlining both the clinical and histopathological findings.
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  • 文章类型: Case Reports
    HIV患者的软疣样皮肤病变可能是各种疾病的表现特征。因此,实验室调查在做出准确的病因诊断中起着至关重要的作用。讨论HIV患者软体动物样病变中通常进行的实验室测试结果的研究非常稀疏。因此,我们进行了一项研究来弥合这一文献空白。这项研究是在四名患有软体动物样皮肤病变的HIV患者中进行的。对所有患者进行shave活检,并将标本送去氢氧化钾(KOH)安装/克染色,真菌培养和组织病理学检查。来自病例1、2、3和4的组织样本被称为样本A,B,C和D,分别。KOH安装在样品A和B中显示出大小约6μm的酵母样圆形体。样品C和D中的KOH安装显示出分隔的分支菌丝。样品C中的KOH安装也显示出大约35μm的大圆形体,其被鉴定为软体动物体。样品A和B的组织病理学显示出提示真菌病的特征,而样品C和D的组织病理学显示出传染性软体动物的特征。Sabouraud葡萄糖琼脂中的培养在样品A中生长了马内菲B和C。通常可用的实验室测试极大地帮助建立软体动物样皮肤病变的诊断。然而,需要清楚地理解实验室测试中的某些细微差别。需要进行更大样本量的研究,以确定痘病毒和马尔尼菲T.如样品C所示。
    Molluscum-like skin lesions in HIV patients can be the presenting feature of the vast array of diseases. Hence, laboratory investigations play a crucial role in making an accurate etiological diagnosis. The studies that discuss the outcomes of commonly performed laboratory tests in molluscum-like lesions in HIV patients are very sparse. Hence, we conducted a study to bridge this literature gap. This study was conducted among four patients with HIV who had molluscum-like skin lesions. Shave biopsy was performed on all the patients and the specimens were sent for potassium hydroxide (KOH) mount/gram stain, fungal culture and histopathological examination. The tissue samples from cases 1, 2, 3 and 4 are mentioned as samples A, B, C and D, respectively. KOH mount showed yeast-like rounded bodies around 6 μm in size in samples A and B. The KOH mount in samples C and D showed septate branching hyphae. KOH mount in sample C also showed large rounded bodies around 35 μm which were identified as molluscum bodies. The histopathology of samples A and B showed features suggestive of talaromycosis whereas the histopathology of samples C and D showed features of molluscum contagiosum. Culture in Sabouraud Dextrose Agar grew T. marneffei in samples A, B and C. The commonly available laboratory tests immensely help in establishing the diagnosis of molluscum-like skin lesions. However, certain nuances in laboratory tests need to be understood lucidly. Studies with larger sample sizes need to be conducted to determine the possible co-infection of poxvirus and T. marneffei, as witnessed in sample C.
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  • 文章类型: Case Reports
    背景:先天性免疫错误是一类越来越多的疾病,具有广泛的基因型和表型特征。CARMIL2(以前称为RLTPR)缺乏症是最近描述的免疫失调的原因,主要表现为过敏,皮肤粘膜感染,和炎症性肠病.CARMIL2缺乏被归类为免疫失调的疾病,具有对淋巴增生性病症的易感性。
    方法:这里我们描述了一个来自近亲家庭的29岁男性,食物和刺痛过敏,过敏性鼻炎,面部传染性软体动物(以脐带丘疹形式的皮肤病毒感染),嗜酸性粒细胞增多和血清IgE水平高度升高。全外显子组测序揭示了许多纯合变体,包括CARMIL2无意义突变,调节肌动蛋白聚合的基因,促进细胞突起形成。
    结论:CARMIL2在通过细胞-骨骼组织的T细胞活化和成熟中的选择性作用被认为是CARMIL2缺乏个体免疫失调的原因。CARMIL2在免疫通路调节中具有重要作用,通过细胞成熟和分化,在Th1、Th2和Th17免疫应答之间产生平衡。该病例可提高对CARMIL2突变对免疫通路不同影响的认识,进一步指导表型相似患者的诊断。
    BACKGROUND: Inborn errors of immunity are a growing group of disorders with a wide spectrum of genotypic and phenotypic profiles. CARMIL2 (previously named RLTPR) deficiency is a recently described cause of immune dysregulation, mainly presenting with allergy, mucocutaneous infections, and inflammatory bowel disease. CARMIL2 deficiency is categorized under diseases of immune dysregulation with susceptibility to lymphoproliferative conditions.
    METHODS: Here we describe a 29-years-old male from a consanguineous family, with food and sting allergy, allergic rhinitis, facial molluscum contagiosum (viral infection of the skin in the form of umbilicated papules), eosinophilia and highly elevated serum IgE level. Whole exome sequencing revealed numerous homozygous variants, including a CARMIL2 nonsense mutation, a gene regulating actin polymerization, and promoting cell protrusion formation.
    CONCLUSIONS: The selective role of CARMIL2 in T cell activation and maturation through cytoskeletal organization is proposed to be the cause of immune dysregulation in individuals with CARMIL2 deficiency. CARMIL2 has an important role in immune pathways regulation, through cell maturation and differentiation, giving rise to a balance between Th1, Th2, and Th17 immune response. This case can improve the understanding of the different impacts of CARMIL2 mutations on immune pathways and further guide the diagnosis of patients with similar phenotypes.
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  • 文章类型: Case Reports
    传染性软疣(MC)是儿童常见的病毒性皮肤感染。它的特点是脐带,皮肤颜色的丘疹,通常在不治疗的情况下在几个月到几年内消退。对病毒的免疫反应可能会引起炎症反应,包括软疣性皮炎,发炎的软体动物,Gianotti-Crosti综合征样反应,环带红斑离心机,甚至是广义的id反应(由刺激免疫系统的单独条件驱动的反应性炎症过程)。我们报告了一例独特的病例,该病例继发于对MC的免疫识别,随后迅速解决了其MC。
    Molluscum contagiosum (MC) is a viral cutaneous infection common in children. It is characterized by umbilicated, skin-colored papules that typically resolve without treatment over several months to years. Immune response to the virus may cause inflammatory reactions, including molluscum dermatitis, inflamed molluscum, Gianotti-Crosti syndrome-like reaction, erythema annulare centrifugum, or even a generalized id reaction (a reactive inflammatory process driven by a separate condition that stimulates the immune system). We report a unique case of a granuloma annulare-like id reaction secondary to immune recognition of MC in a pediatric patient followed by rapid resolution of their MC.
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  • 文章类型: Case Reports
    传染性软疣(MC)是一种常见的良性皮肤病毒感染。它可以影响皮肤的任何部分,对面部皮肤有很高的倾向,特别是在人类免疫缺陷病毒(HIV)患者的低CD4计数。我们报告了一例16岁的女性患者,该患者患有巨大的孤立的右上眼睑MC病变,这是她的HIV感染和获得性免疫缺陷综合症(AIDS)的第一个临床指标。根据病史对MC进行最终诊断,临床发现,和组织病理学检查。此外,由于它的重要位置,大尺寸,和非典型的介绍,在局部麻醉下通过简单的去顶和刮宫进行手术切除以加速恢复,预防角膜并发症,减少传输。她的随访显示出令人满意的临床和美容结果。表现为巨大的非典型眼睑病变的患者必须彻底调查免疫抑制状态,尤其是HIV感染。MC在HIV患者中可以有非典型表现。据我们所知,这是文献中报道巨大的孤立性眼睑MC病变导致诊断为HIV感染和AIDS的少数病例之一。
    Molluscum contagiosum (MC) is a common benign cutaneous viral infection. It can affect any part of the skin with a high propensity for facial skin, especially in human immunodeficiency virus (HIV) patients with low CD4 count. We report a case of a 16-year-old female patient who presented with a giant isolated right upper eyelid MC lesion that served as the first clinical indicator of her HIV infection and acquired immunodeficiency syndrome (AIDS). A final diagnosis of MC was made based on the history, clinical findings, and histopathological examination. Moreover, due to its vital location, large size, and atypical presentation, a surgical excision by simple unroofing and curettage was performed under local anesthesia to speed recovery, prevent corneal complications, and reduce transmission. Her follow-up visits showed satisfactory clinical and cosmetic outcomes. Patients presenting with giant atypical eyelid lesions must be thoroughly investigated for immunosuppressive states, especially HIV infection. MC can have atypical presentations in HIV patients. To our knowledge, this is one of a few cases in the literature reporting a giant isolated eyelid MC lesion leading to a diagnosis of HIV infection with AIDS.
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  • 文章类型: Case Reports
    背景:传染性软疣病毒(MCV)是一种良性的,常见的皮肤感染主要影响年轻的儿科人群。传统治疗可能是耗时的,具有可变的功效。自发消退的时间是可变的,通常寻求治疗以缩短感染持续时间。防止进一步的自体接种,防止传染性传播给他人并治疗化妆品的不耐受性。
    方法:我们介绍了两名患者的情况,在接受2018年常规四价流感疫苗接种后,同时清除传染性软疣感染。两名患者均未复发传染性软疣或永久性疤痕。我们回顾了病灶内免疫疗法治疗皮肤感染的试验,以理论上阐明流感疫苗接种后MCV感染清除机制。
    结论:我们提出一种迟发型超敏反应被诱导为流感疫苗接种的一种异源效应,类似于目前的免疫治疗。这是第一例报道的针对MCV的免疫反应在流感疫苗接种后具有感染清除的病例。
    Molluscum contagiosum virus (MCV) is a benign, common cutaneous infection predominantly affecting the younger pediatric population. Traditional treatments may be time consuming with variable efficacy. Time to spontaneous resolution is variable and treatment is often sought to shorten duration of infection, prevent further autoinoculation, prevent infectious spread to others and treat cosmetic intolerability.
    We present the case of two patients with complete, simultaneous clearance of their molluscum contagiosum infections after receiving a routine 2018 quadrivalent influenza vaccination. Neither patient has had recurrence of molluscum contagiosum or permanent scarring. We review trials of intralesional immunotherapy in treatment of cutaneous infections to theorize the mechanism of MCV infection clearance post influenza vaccination.
    We propose a delayed-type hypersensitivity reaction was induced as a heterologous effect of the influenza vaccination, similar to that seen in current immunotherapy treatments. This is the first reported case of MCV-directed immune reaction with infection clearance after influenza vaccination.
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  • 文章类型: Case Reports
    传染性软疣(MC)是由Fingolimod已经报道的DNA痘病毒家族病毒引起的皮肤感染。我们报告了两个案例。MC可以抵抗标准治疗,停药芬戈莫德可能是治疗它的唯一方法。
    Molluscum contagiosum (MC) is a skin infection caused by a virus of the DNA poxvirus family that has already been reported by Fingolimod. We report two cases. MC can resist standard therapy and discontinuation of the fingolimod may be the only way to treat it.
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  • 文章类型: Journal Article
    用作免疫系统调节剂的多种药物的使用在患有严重自身免疫疾病的患者中是常见的。在这些临床场景中,应高度重视诊断可能导致医源性免疫抑制的感染性皮肤疾病。在这里,我们报道了一例罕见的传染性软体动物在类风湿关节炎的免疫调节治疗过程中出现面部和头皮上的爆发,具有临床和皮肤镜特征。
    The use of multiple drugs acting as modulators of the immune system are common among patients with severe autoimmune diseases. In these clinical scenarios, great attention should be placed on diagnosing infective cutaneous disorders that can underly iatrogenic immunosuppression. Here within, we report a rare case of molluscum contagiosum eruption on the face and the scalp during an immunomodulating treatment for rheumatoid arthritis, with clinical and dermatoscopic characterization.
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  • 文章类型: Case Reports
    背景:传染性软疣,痘病毒感染,可能发生在眼睑皮肤;然而,由软体动物病变引起的角膜受累极为罕见。我们报告了一例未经治疗的AIDS患者在角膜缘出现的传染性软体动物,以及切除肿瘤的前节光学相干断层扫描(OCT)发现和组织病理学。
    方法:一名46岁的艾滋病患者被转诊到我们部门治疗眼部病变。血液测试显示,CD4+T细胞计数极低,为11个细胞/μL,具有高拷贝数HIVRNA(8070.0×100拷贝/mL)的抗HIV抗体(591.36S/CO)强阳性。他右眼的裂隙灯检查显示下角膜缘有一个白色结节。结节的前段OCT发现显示高度反射的隆起病变,这被认为涉及鲍曼层。结节性病变从角膜缘切除,包括浅层角膜基质,然后进行组织学检查。切除病变的组织病理学显示,棘皮角膜上皮含有肿胀的细胞,嗜酸性包裹体称为软体动物体。他被诊断出患有传染性软体动物。
    结论:前节OCT的发现为传染性软疣的形态学评估和术前策略提供了有用的信息。
    BACKGROUND: Molluscum contagiosum, a pox virus infection, is likely to occur in the eyelid skin; however, corneal involvements by molluscum lesions are extremely rare. We report a case of molluscum contagiosum arising in the corneal limbus in an untreated AIDS patient, together with anterior segment optical coherence tomography (OCT) findings and histopathology of the excised tumor.
    METHODS: A 46-year-old man with AIDS was referred to our department for the management of an ocular lesion. Blood tests revealed an extremely low CD4+ T-cell count of 11 cells/μL, being strongly positive for anti-HIV antibody (591.36 S/CO) with a high copy number of HIV RNA (8070.0 × 100 copy/mL). Slit-lamp examination of his right eye showed a white nodule at the lower limbus. Anterior segment OCT findings of the nodule revealed a highly reflective elevated lesion, which was considered to involve the Bowman layer. The nodular lesion was excised from the limbus including the superficial corneal stroma, and then processed for histologic examination. Histopathology of the excised lesion showed acanthotic corneal epithelium containing swollen cells with eosinophilic inclusions known as molluscum bodies. He was diagnosed with molluscum contagiosum.
    CONCLUSIONS: Anterior segment OCT findings provide useful information for morphological evaluations of and preoperative strategies against molluscum contagiosum.
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  • 文章类型: Journal Article
    开始抗逆转录病毒治疗(ART)的人类免疫缺陷病毒(HIV)阳性患者的矛盾免疫重建炎症综合征(IRIS)是由对特定抗原的免疫力恢复引起的,导致先前存在的感染恶化。传染性软疣(MC)在HIV阳性个体中很常见,但单独的ART通常足以解决。我们提出了一个罕见的严重MC-IRIS病例,尽管免疫重建,但其恶化。
    结论:传染性软疣是一种常见的机会性感染,在免疫功能低下的个体中可能有严重的表现。仅抗逆转录病毒治疗通常足以清除感染,然而,尽管免疫重建,难治性病例仍然可以持续。免疫重建炎性综合征未能改善或恶化,应引起对其他免疫功能障碍的怀疑。手术,细胞破坏疗法和化疗药物可以考虑广泛,持续性疾病。
    Paradoxical immune reconstitution inflammatory syndrome (IRIS) in human immunodeficiency virus (HIV)-positive patients initiating antiretroviral treatment (ART) is caused by restored immunity to specific antigens, resulting in worsening of a pre-existing infection. Molluscum contagiosum (MC) is commonly noted in HIV-positive individuals but ART alone is usually sufficient to bring about resolution. We present a rare case of severe MC-IRIS that worsened despite immune reconstitution.
    CONCLUSIONS: Molluscum contagiosum is a common opportunistic infection which can have severe manifestations in immunocompromised individuals.Antiretroviral treatment alone is usually sufficient to clear the infection, however refractory cases can persist despite immune reconstitution.Failure to improve or worsening immune reconstitution inflammatory syndrome should raise suspicion for additional immunological dysfunction.Surgery, cytodestructive therapies and chemotherapeutic agents can be considered in extensive, persistent disease.
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