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2005, Number 1

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Rev Fac Med UNAM 2005; 48 (1)

Molluscum contagiosum in an Aids patient

Carrada BT

Language: Spanish
References: 23
Page: 10-13
PDF size: 81.56 Kb.


ABSTRACT

Molluscum contagiosum (MC) is a common and at times severely disfiguring cutaneous viral infection in patients with acquired immunodeficiency syndrome (AIDS). The purpose of this study is to describe the clinical manifestations of MC in a patient infected with human immunodeficiency virus (HIV) and to review the value of the diagnostic laboratory methods. It is the case of a male homosexual with facial and genital MC lesions and HIV infection, who had T-cell CD4+ subset determinations. A skin biopsy revealed lobules of keratinocytes containing large eosinophilic intracytoplasmic inclusion bodies (Henderson-Patterson bodies). The etiologic diagnosis was confirmed by direct electronmicroscopy examination and negative stain of viral particles. The patient had a poor response to topical treatments with liquid nitrogen, curettage and skin peeling with trichloroacetic acid. There was some improvement after the use of indinavir plus ritonavir, and the viral load decreased from 261,100 copies per milliliter to 193,500 copies per mL and the clinical status remained stable. MC may serve as a cutaneous marker of severe cellular immunodeficiency.


REFERENCES

  1. Magaña-García M. Guía de Dermatología Pediátrica. Bogotá: Edit Med Panamericana, 1988: 101-103.

  2. Douglas JM. Molluscum contagiosum. In: Holmes KK, Mardh PA, Sparling PF, Wiesner PJ, Cates W, Lemon SM y cols. Sexually Transmissible Diseases, 2a ed, Nueva York: McGraw-Hill 1990: 443-447.

  3. Schwartz JJ, Myskowski PL. Molluscum contagiosum in patients with human immunodeficiency virus infection. J Am Acad Dermatol 1992; 27: 583-588.

  4. Janis B. Molusco contagioso. En: Hoeprich PD. Tratado de Enfermedades Infecciosas. Barcelona: Salvat, 1982: 767-796.

  5. Cotell SL, Roholt NS. Molluscum Contagiosum in a Patient with the Acquired Immunodeficiency Syndrome. N Engl J Med 1998; 36: 888.

  6. Swain RHA, Dodds TC. Clinical Virology. Edinburgh y London: Livingstone Ltd, 1967: 9 y 118-120.

  7. Sutton JS, Burnett JW. Ultrastructural changes in dermal and epidermal cells of skin infected with molluscum contagiosum virus. J Ultrastr Res 1969; 26: 177-196.

  8. Nelson JA, Ghazal P, Wiley CA. Role of opportunistic viral infections in AIDS. AIDS 1990; 4: 1-10.

  9. Coldiron BM, Bergstresser PR. Prevalence and Clinical spectrum of Skin Diseases in Patients Infected with Human Immunodeficiency Virus. Arch Dermatol 1989; 125: 357-361.

  10. Johnson RA, Dover JS. Cutaneous Manifestations of Human Immunodeficiency Virus Disease. En: Fitzpatrick TB, Eisen AZ, Wolff K, Freeberg IM, Austen KF eds. Dermatology in General Medicine. 4a ed, vol II. Nueva York, N. Y: McGraw-Hill Inc, 1993: 2637-2689.

  11. Matis WL, Triana A, Shapiro R. Dermatologic findings associated with human immunodeficiency virus infection. J Am Acad Dermatol 1987; 17: 746-751.

  12. González-Benavides J, González-González S, Elizondo-Elizondo A. Manifestaciones cutáneas en el síndrome de inmunodeficiencia adquirida. Estudio de 183 pacientes. Dermatología Rev Méx 1994; 38: 46-49.

  13. Vick R, Vargas-Avilés AS, Castro G, Córdoba VH, Fabián MG, Arenas R. Manifestaciones dermatológicas en el síndrome de inmunodeficiencia adquirida. Estudio de 46 pacientes. Dermatología Rev Mex 1995; 38: 197-201.

  14. Sindrup JH, Weisman K, Petersen CS. Skin and oral mucosal changes in patients infected with human immunodeficiency virus. Acta Derm Venereol (Stockh) 1988; 68: 440-443.

  15. Rosenberg EW, Yusk JW. Molluscum contagiosum: eruption following treatment with prednisone and methotrexate. Arch Dermatol 1970; 10: 439-441.

  16. Helliet FF. Profuse molluscum contagiosum of the face induced by corticosteroids. Br J Dermatol 1971; 85: 398.

  17. Cotton DWK, Cooper C, Barret DF. Severe atypical molluscum contagiosum infection in an immunocompromised host. Br J Dermatol 1987; 116: 871-876.

  18. Hong MC, Steuer ME, Levy A. Lack of host cellular immune response in eruptive molluscum contagiosum. Am J Dermatopathol 1989; 11: 248-254.

  19. Steffen C, Markman J. Spontaneous disappearance of molluscum contagiosum. Arch Dermatol 1980; 116: 923-924.

  20. Miller V, Mocroft A, Reiss P. Relations among CD4 lymphocyte count nadir, antiretroviral therapy, and HIV-I disease progression: results from the EuroSIDA study. Ann Intern Med 1999; 130: 570-577.

  21. Orozco-Topete R. Manifestaciones dermatológicas en el paciente con SIDA. Dermatología Rev Mex 1992; 36: 236-246.

  22. Hernández-Girón C, Tovar-Guzmán V, del Río C. AIDS mortality trends in Mexico, 1988-1997. Salud Pública Mex 2002; 44: 207-212.

  23. Secretaría de Salud de México. Estadísticas de mortalidad en México: muertes registradas en el año 2001. Salud Pública Mex. 2002; 44: 573-577.




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