Molluscum contagiosum diagnostic criteria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
There are no criteria for the diagnosis of molluscum contagiosum. Although the diagnosis is usually based on characteristic appearance of the lesions, other diagnostic studies including histologic examination, dermoscopic examination and electron microscopy of biopsies can be helpful for diagnosis as well.
Diagnostic criteria
- histologic examination can confirm the clinical diagnosis. Hematoxylin and eosin staining of a molluscum contagiosum lesion typically reveals keratinocytes containing eosinophilic cytoplasmic inclusion bodies (also known as molluscum bodies or Henderson-Paterson bodies).
- Dermoscopic examination can be useful for supporting a clinical diagnosis of molluscum contagiosum. Visualization of a central umbilication with polylobular, white to yellow amorphous structures is typical. The dermoscope allows physicians to examine the macroscopic and microscopic primary morphology of skin lesions, identify subtle clinical clues, confirm naked-eye clinical diagnoses, and monitor treatment progress while posing little threat to the young patient. [1] [2]
- A peripheral crown of radiating or punctiform vessels is also present. Dermoscopy performed on molluscum contagiosum lesions proved superior to dermatological examination even in cases in which clinical diagnosis was difficult. The presence of orifices, vessels and specific vascular patterns aids diagnosis, including differential diagnosis with other types of skin lesion. [3]
- Although usually not indicated, electron microscopy of biopsies demonstrates typical brick-shaped poxvirus particles. Electron microscopy can also identify infected cells that appear normal on light microscopy. [4]
References
- ↑ Haliasos EC, Kerner M, Jaimes-Lopez N, Rudnicka L, Zalaudek I, Malvehy J, Hofmann-Wellenhof R, Braun RP, Marghoob AA (2013). "Dermoscopy for the pediatric dermatologist part I: dermoscopy of pediatric infectious and inflammatory skin lesions and hair disorders". Pediatr Dermatol. 30 (2): 163–71. doi:10.1111/pde.12097. PMID 23405886.
- ↑ Morales A, Puig S, Malvehy J, Zaballos P (2005). "Dermoscopy of molluscum contagiosum". Arch Dermatol. 141 (12): 1644. doi:10.1001/archderm.141.12.1644. PMID 16365277.
- ↑ Ianhez M, Cestari Sda C, Enokihara MY, Seize MB (2011). "Dermoscopic patterns of molluscum contagiosum: a study of 211 lesions confirmed by histopathology". An Bras Dermatol. 86 (1): 74–9. PMID 21437525.
- ↑ Smith KJ, Skelton HG, Yeager J, James WD, Wagner KF (1992). "Molluscum contagiosum. Ultrastructural evidence for its presence in skin adjacent to clinical lesions in patients infected with human immunodeficiency virus type 1. Military Medical Consortium for Applied Retroviral Research". Arch Dermatol. 128 (2): 223–7. PMID 1739301.