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Address for correspondence: Dr Silpi Basak, Professor and Head, Department of Microbiology, Jawaharlal Nehru Medical College,
Wardha (M.S.) – 442 004, India. E-mail : drsilpibasak@gmail.com
Indian Medical Gazette — JULY 2013 277
Diagnosis is confirmed by excisional biopsy and in 2011 have described that after incision with a 19 gauge
examination under low power microscope shows ovoid, needle, a comedone extractor is used to express the cheesy
smooth walled homogeneous cytoplasmic masses which core. The cheesy core is squashed or pressed between 2
mainly consists of mature, immature and incomplete virion glass microscopic slides. The smears are stained with 5-7
alongwith cellular debris. These are called as molluscum drops of Giemsa stain and observed under microscope to
bodies 20-30µm in size, which displace the nuclei to the see the Henderson –Paterson bodies. Other staining
periphery of the cell. In molluscum bodies, large numbers techniques e.g. Wright, 10% KOH, Gram and Papanicolaou
of virus particles are embedded in protein matrix. have been described 11, 12, 13, 14.
Molluscum bodies are the inclusion bodies of Molluscum
contagiosum virus. Wright’s Giemsa strain, Haematoxylin Prevention
& eosin staining can be done. The section shows acanthoma The patient is advised not to scratch or pick at the
with downward proliferation of rete ridges. As the bumps, not to share the towels, wash cloths and other
molluscum bodies reach the level of granular cell layers, personal items, not to share the skin that has lesion, in ano-
their staining reaction changes from eosinophilic to genital lesions not to have sex.
basophilic. In the horny cell layer, molluscum bodies are
basophilic and called as Henderson-Patterson bodies1. The Treatment
stratum corneum in the centre of the lesion disintegrate
and release the molluscum bodies and there is formation of Many treatment modalities have been described but exact
central crater. Usually, no inflammatory reaction is seen in treatment option depends upon patient’s age, immune status,
the dermis. Inflammatory reaction is seen when the lesion site of lesion etc.
is ruptured, and the contents of the lesion is discharged i. Cryosurgery – The bumps are frozen with liquid
into the dermis. Spontaneously involuting lesion shows a nitrogen.
mononuclear infiltrate surrounding the lesion, which also
infiltrate between infected epidermal cells. Actually histologic ii. Curettage – The bumps can be scraped of the skin
section stained with hematoxyline and eosin shows a cup by using a curatte.
shaped indentation of epidermis into dermis.
iii. Laser surgery – Laser can be used to destroy the
Molluscum lesions usually resolve within 6-9 months bumps.
but may persist for 2 years. MCV do not remain latent in
iv. Electrodessication – It is more effective in
the body like Herpes virus, when the lesion resolve from
immunocompromised hosts.
the skin, it will not appear on their own7. But there is no
permanent immunity to MCV and the individual can again v. Topical agents – Various acids e.g. Trichloro acetic
be infected on exposure to an infected person. acid or blistering solution can be used to destroy
the bumps. Astringents like potassium
In immunocompetent host the differential diagnosis of
hydrochloride, cantharidium can be used. Similarly,
molluscum lesions include varicella, lichen planus, Darier’s
essential oils e.g. Australian lemon myortie and tae
disease, histiocytoma, basal cell epithelioma,
tree oil with organically bound iodine can be used.
keratoacanthoma, verruca vulgaris, condyloma accuminata,
10% Benzyl peroxide, Imiquimod, Retinoid can also
warts, dermatitis herpetiformis etc8, 9. Warts lack the central
be used over the bumps. In extensive lesions
umblication and usually occur on palm and soles. Herpes
antiviral drugs i.e. Cidofovir is used.
lesions are vesicle, tender and have a rapid onset and shorter
clinical course.
Prognosis
Polymerase chain reaction (PCR) can also be done for Molluscum lesions clears up within 2 years. The lesions
diagnosis. Lydia et al have described the technique of are contagious as long as the skin growths are present.
Squash preparation using Giemsa stain for inoffice diagnosis Advantage of the treatment is to hasten the resolution of
of molluscum lesion10. In Squash preparation, the cellular virus. Low CD4 cell counts have been linked to widespread
exudates can be observed under microscope. Lydia et al. facial mollusca and therefore have become a marker for
278 Indian Medical Gazette — JULY 2013
severe HIV disease 15. Therefore, therapies have been recipient. Transpl Infect Dis. 6:120-123, 2004.
targeted for boosting the immune system in these patients16.
10. Eleftheriou L.I., Kerr S.C., Stratman E.J. —
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