Histopathologic Finding and Pathophysiology Pathway of Moluskum Kontangiosum

Abstract

Introduction: Molluscum contagiosum is endemic in densely populated communities, poor hygiene, and poor areas. This disease mainly affects children, adults with active sexual activity and immunodeficiency status. Transmission can be through direct contact with active lesions or autoinoculation, indirect transmission through sharing personal tools such as towels, razors, hair clippers and transmission through sexual contact. The prevalence of Molluscum contagiosum in the world varies. In the US it is 33%, in Mali 3.6%, in Australia the overall seropositivity rate is 23%, in East Africa it is 52% in children aged 2 years. The incidence of molluscum contagiosum worldwide is estimated at 2% - 8%, with a prevalence of 5% - 18% in HIV/AIDS patients. Molluscum contagiosum virus type-1 (MCV-1) was the most common subtype found in patients, whereas MCV-3 was rare. For example, analysis of 106 clinically isolated MCVs indicated the presence of MCV-1, -2, and -3 in an 80:25:1 ratio. In addition, MCV-2 was found to be more common in adults. Discussion: Cystic changes in superficial MCV lesions may occur. There is a small ostium opening to the skin surface, which potentially connects the MCV and facilitates the extension of the MCV from the infected EIC to the adjacent skin. Several poxviruses can determine persistent infection in cell culture. The rate of infection in adults with AIDS raises the possibility of reactivation of subclinical infection in the setting of immunosuppression. While genital lesions are found in sexually active adults.Histopathology of molluscum contagiosum shows a proliferation of stratum spinosum cells that form lobules with central cellular and viral debris. The intraepidermal lobules are separated by connective tissue septa and the molluscum bodies in the lobules are found in the form of round or oval cells that undergo keratohyaline degeneration. In the stratum basalis, there is a picture of cell mitosis with enlarged basophilic nuclei. In the advanced phase, cells that undergo a cytoplasmic vacuolization process can be found and eosinophilic globies are obtained. In several cases of molluscum contagiosum lesions with secondary infection, the predominant inflammatory picture of lymphocytes and neutrophils was found on histopathological examination. Conclusion: Widespread involvement of eczematous areas has been described in patients with atopic dermatitis and is associated with skin disorders, use of topical steroids, and/or underlying disorders. Patients with HIV infection have a marked increase in infection. It was first noted in the early years of the AIDS epidemic that molluscum contagiosum in HIV-infected people was recognized as a common opportunistic infection. Both prevalence and severity of disease increase with increasing immunodeficiency, with lesions increasing in up to one third of patients with CD4 cell counts of 100 cells/mm or below.