January 15, 2013
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Inflammatory reaction to molluscum contagiosum common among children

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Children commonly experienced inflammatory reaction to molluscum contagiosum, including symptoms resembling Gianotti-Crosti syndrome, according to study results.

In a retrospective review of medical charts at a pediatric dermatology practice in New York, researchers studied 696 patients (mean age, 5.5 years; 51.7% girls) with molluscum contagiosum (MC). In patients with and without atopic dermatitis (AD), frequencies, characteristics and associated features of inflammatory reactions to MC were used as main outcome measures.

Three hundred seven patients (44.1%) had a history of atopy, including 259 with AD and 138 with asthma or allergies. Two hundred seventy patients (38.8%) had molluscum dermatitis, 155 (22.3%) had inflamed MC lesions, and 34 (4.9%) had Gianotti-Crosti syndrome-like reactions (GCLRs). Among 13 evaluable GCLR patients, mean syndrome duration was 6 weeks. Patients with AD had more MC lesions (P<.001) and an increased likelihood of having molluscum dermatitis compared with patients without AD (50.6% vs. 31.8%; P<.001).

MC lesions increased during 3 months of follow-up in 23.4% of patients with molluscum dermatitis who received topical corticosteroid and 33.3% not treated (P=.44). A smaller number of patients (16.8%) without dermatitis had an increased number of MC lesions during 3 months of follow-up but was not significant.

Patients with inflamed MC lesions were less likely to have additional MC lesions during 3 months of follow-up (5.2% vs. 18.4%; P<.03) than patients without inflamed MC lesions or dermatitis. When GCLRs were associated with inflamed MC lesions [P<.001], they generally were pruritic, favored elbows and knees, and often marked resolution of MC.

“This series documents the frequencies and clinical presentations of inflammatory reactions to MC, highlighting their relationships with one another, AD, and of the course of the MC infection,” the researchers concluded. “Treatment of molluscum dermatitis can reduce the spread of MC via autoinoculation from scratching, whereas inflamed MC lesions and GCLRs reflect cell-mediated immune responses that may lead to viral clearance.”