View source for Molluscum contagiosum differential diagnosis

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[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Molluscum_contagiosum]]
{{CMG}}; {{AE}} {{MIR}}, {{JS}}

==Overview==
[[Molluscum contagiosum]] must be differentiated from other diseases that cause inflammatory or ulcertive [[skin]] , genital, or [[Mucous membrane|mucosal]] lesions including [[chicken pox]], [[herpes zoster]], [[erythema multiforme]], [[cryptococcosis]], [[histoplasmosis]], [[pyogenic granuloma]].

==Differential Diagnosis==
Different conditions that cause a round [[papular]] [[rash]] must be differentiated from [[molluscum contagiosum]] based on the appearance of the [[lesions]] such as:<ref name="pmid25250996">{{cite journal| author=Hartman-Adams H, Banvard C, Juckett G| title=Impetigo: diagnosis and treatment. | journal=Am Fam Physician | year= 2014 | volume= 90 | issue= 4 | pages= 229-35 | pmid=25250996 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25250996  }} </ref><ref name="pmid27265069">{{cite journal| author=Mehta N, Chen KK, Kroumpouzos G| title=Skin disease in pregnancy: The approach of the obstetric medicine physician. | journal=Clin Dermatol | year= 2016 | volume= 34 | issue= 3 | pages= 320-6 | pmid=27265069 | doi=10.1016/j.clindermatol.2016.02.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27265069  }} </ref><ref name="MooreSeward2006">{{cite journal|last1=Moore|first1=Zack S|last2=Seward|first2=Jane F|last3=Lane|first3=J Michael|title=Smallpox|journal=The Lancet|volume=367|issue=9508|year=2006|pages=425–435|issn=01406736|doi=10.1016/S0140-6736(06)68143-9}}</ref><ref name="pmid26612370">{{cite journal| author=Ibrahim F, Khan T, Pujalte GG| title=Bacterial Skin Infections. | journal=Prim Care | year= 2015 | volume= 42 | issue= 4 | pages= 485-99 | pmid=26612370 | doi=10.1016/j.pop.2015.08.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26612370  }} </ref><ref name="pmid26566601">{{cite journal| author=Ramoni S, Boneschi V, Cusini M| title=Syphilis as "the great imitator": a case of impetiginoid syphiloderm. | journal=Int J Dermatol | year= 2016 | volume= 55 | issue= 3 | pages= e162-3 | pmid=26566601 | doi=10.1111/ijd.13072 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26566601  }} </ref><ref name="pmid25855021">{{cite journal| author=Kimura U, Yokoyama K, Hiruma M, Kano R, Takamori K, Suga Y| title=Tinea faciei caused by Trichophyton mentagrophytes (molecular type Arthroderma benhamiae ) mimics impetigo : a case report and literature review of cases in Japan. | journal=Med Mycol J | year= 2015 | volume= 56 | issue= 1 | pages= E1-5 | pmid=25855021 | doi=10.3314/mmj.56.E1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25855021  }} </ref><ref name="pmid23176858">{{cite journal| author=CEDEF| title=[Item 87--Mucocutaneous bacterial infections]. | journal=Ann Dermatol Venereol | year= 2012 | volume= 139 | issue= 11 Suppl | pages= A32-9 | pmid=23176858 | doi=10.1016/j.annder.2012.01.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23176858  }} </ref>
{| class="wikitable sortable"
! style="width: 200px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Disease}}
! style="width: 200px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Features}}
! style="width: 200px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Images}}
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| style="background: #DCDCDC; padding: 5px;" |Molluscum contagiosum
|
*Skin [[papules]]:
**Firm
**Dome shaped
**Shiny
**2 to 5 mm diameter
**May have central indentation or [[umbilication]]
*Polypoid lesion: Occasionally, with a stalk-like base
*Visibly inflamed lesions occasionally may be seen
*[[Erythema|Diffuse erythema]]: May be seen due to [[Gianotti-Crosti syndrome|Gianotti-Crosti]] like eruptions
|
[[File:Molluscumcontagiosum1.jpg|300px]]
|-
| style="background: #DCDCDC; padding: 5px;" |[[Cryptococcosis]]<ref name="pmid26936349">{{cite journal |vauthors=Miyazato A |title=[Mechanism of Cryptococcus Meningoencephalitis] |language=Japanese |journal=Med Mycol J |volume=57 |issue=1 |pages=J27–32 |year=2016 |pmid=26936349 |doi=10.3314/mmj.57.J27 |url=}}</ref> 
|
*Caused by encapsulated yeast ([[fungus]]) [[Cryptococcus neoformans]]
*May be completely asymptomatic
*May have latent infection or symptomatic disease
*[[Pneumonia]]-like illness with [[fever]], [[cough]], [[sputum]] production and [[chest pain]]
*May lead to:
**[[Meningoencephalitis]] 
|
[[File:Cryptococcosis05.jpeg|300px]]
|-
| style="background: #DCDCDC; padding: 5px;" |[[Histoplasmosis]]<br> <ref name="pmid20463244">{{cite journal| author=Knox KS, Hage CA| title=Histoplasmosis. | journal=Proc Am Thorac Soc | year= 2010 | volume= 7 | issue= 3 | pages= 169-72 | pmid=20463244 | doi=10.1513/pats.200907-069AL | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20463244  }} </ref><ref name="pmid19375629">{{cite journal| author=Kauffman CA| title=Histoplasmosis. | journal=Clin Chest Med | year= 2009 | volume= 30 | issue= 2 | pages= 217-25, v | pmid=19375629 | doi=10.1016/j.ccm.2009.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19375629  }} </ref><ref name="pmid18158437">{{cite journal |author=Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL |title=Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008 |journal=[[Critical Care Medicine]] |volume=36 |issue=1 |pages=296–327 |year=2008 |month=January |pmid=18158437 |doi=10.1097/01.CCM.0000298158.12101.41 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0090-3493&volume=36&issue=1&spage=296 |accessdate=2012-09-16}}</ref><ref>Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.</ref>
|
*Acquired via inhalation of airborne microconidia
*Can present with:
**Acute pulmonary [[histoplasmosis]] presenting with [[fever]], [[cough]] and [[dyspnea]]
**[[Skin rash]]
**Symmetrical [[joint pain]]
**Disseminated [[histoplasmosis]] presents with:
***[[Sepsis]] 
***[[Acute respiratory distress syndrome|Acute respiratory distress syndrome]]
***[[Disseminated intravascular coagulation]]
|
[[File:Histoplasmosis07.jpeg|300px]]
|-
| style="background: #DCDCDC; padding: 5px;" |[[Penicillium marneffei]]<ref name="pmid1339213">{{cite journal| author=Supparatpinyo K, Chiewchanvit S, Hirunsri P, Baosoung V, Uthammachai C, Chaimongkol B et al.| title=An efficacy study of itraconazole in the treatment of Penicillium marneffei infection. | journal=J Med Assoc Thai | year= 1992 | volume= 75 | issue= 12 | pages= 688-91 | pmid=1339213 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1339213  }} </ref> 
|
*[[Fever]]
*[[Skin lesion]]s
*[[Anemia]]
*Generalized [[lymphadenopathy]]
*[[Hepatomegaly]]
|

|-
| style="background: #DCDCDC; padding: 5px;" |[[Condyloma acuminatum]] <ref name="Bloomberg">[http://www.bloomberg.com/apps/news?pid=20601202&sid=aajzweDaXZh0&refer=healthcare Cortez, Michelle Fay and Pettypiece, Shannon. "Merck Cancer Shot Cuts Genital Warts, Lesions in Men". ''Bloomberg News''. (Bloomberg.com) 13 Nov 2008.]</ref>
|
*Occur in [[Cluster (epidemiology)|clusters]] 
*May be very tiny
*May spread into large masses in the [[genital]] or [[penis]] area
|
[[File:Condyloma acuminatum07.jpg|300px]]
|-
| style="background: #DCDCDC; padding: 5px;" |[[Pyogenic granuloma]]<ref name="Fitz2">Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.</ref><ref name="joralsci">{{cite journal | author = Jafarzadeh H, Sanatkhani M, Mohtasham N | title = Oral pyogenic granuloma: a review | journal = J Oral Sci | volume = 48 | issue = 4 | pages = 167–75 |date=December 2006 | pmid = 17220613 | doi = 10.2334/josnusd.48.167| url = http://joi.jlc.jst.go.jp/JST.JSTAGE/josnusd/48.167?from=PubMed| accessdate = 2009-01-04 | format =  &ndash; <sup>[http://scholar.google.co.uk/scholar?hl=en&lr=&q=intitle%3AOral+pyogenic+granuloma%3A+a+review&as_publication=J+Oral+Sci&as_ylo=2006&as_yhi=2006&btnG=Search Scholar search]</sup>}} {{dead link|date=March 2009}}</ref><ref name="Nthumba">{{cite journal |author=Nthumba PM |title=Giant pyogenic granuloma of the thigh: a case report |journal=J Med Case Reports |volume=2 |issue= 1|pages=95 |year=2008 |pmid=18377654 |pmc=2329656 |doi=10.1186/1752-1947-2-95 |url=http://www.jmedicalcasereports.com/content/2//95}}</ref>
|
*A vascular lesion occurs on both [[Mucosal|mucosa]] and skin 
*Appears as an [[hyperplasia|overgrowth]] of tissue due to [[irritation]], [[physical trauma]] or [[hormones|hormonal]] factors 
*Involve the gums, the skin and [[nasal septum]], and has also been found far from the head such as in the thigh
|
[[File:Granuloma pyogenic 16.jpeg|300px]]
|-
| style="background: #DCDCDC; padding: 5px;" |[[Langerhans cell histiocytosis]]<ref name="pmid25310214">{{cite journal| author=Grana N| title=Langerhans cell histiocytosis. | journal=Cancer Control | year= 2014 | volume= 21 | issue= 4 | pages= 328-34 | pmid=25310214 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25310214  }} </ref><ref name="pmid26414464">{{cite journal| author=Harmon CM, Brown N| title=Langerhans Cell Histiocytosis: A Clinicopathologic Review and Molecular Pathogenetic Update. | journal=Arch Pathol Lab Med | year= 2015 | volume= 139 | issue= 10 | pages= 1211-4 | pmid=26414464 | doi=10.5858/arpa.2015-0199-RA | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26414464  }} </ref><ref name="pmid25281259">{{cite journal| author=DiCaprio MR, Roberts TT| title=Diagnosis and Management of Langerhans Cell Histiocytosis. | journal=J Am Acad Orthop Surg | year= 2014 | volume= 22 | issue= 10 | pages= 643-652 | pmid=25281259 | doi=10.5435/JAAOS-22-10-643 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25281259  }} </ref><ref name="wiki">Langerhans cell histiocytosis. Wikipedia (2015) https://en.wikipedia.org/wiki/Langerhans_cell_histiocytosis Accessed on February, 2 2016</ref><ref name="radio">Langerhans cell histiocytosis. Radiopeadia (2015) http://radiopaedia.org/articles/langerhans-cell-histiocytosis Accessed on February, 3 2016</ref>
|
*Result of either a true [[neoplastic]] process or a reactive [[immune]] condition.
*Common symptoms of Langerhans cell histiocytosis include:
**[[Bone]] pain
**[[Rash]]
**[[Fever]]
**[[Failure to thrive]]
*Scaly [[Erythema|erythematous lesions]] located on the scalp and extremities
*Localized [[bone]] [[tenderness]]
*[[Hepatosplenomegaly]]
|
[[File:Langerhans cell histiocytosis08.jpg|300px]]
|-
| style="background: #DCDCDC; padding: 5px;" |[[Basal cell carcinoma]]<ref>{{cite journal |author=Epstein EH, Shepard JA, Flotte TJ |title=Case records of the Massachusetts General Hospital. Case 3-2008. An 80-year-old woman with cutaneous basal-cell carcinomas and cysts of the jaws |journal=N Engl J Med |volume=358 |issue=4 |pages=393–401 |year=2008 |month=Jan |pmid=18216361 |doi=10.1056/NEJMcpc0707893 |url=}}</ref>

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* Skin growths on sun-exposed skin
* [[Ulcerated lesion|Ulcerative pupils]]
|
[[File:Basal cell carcinoma 01.jpeg|300px]]
|-
| style="background: #DCDCDC; padding: 5px;" |[[Amelanotic melanoma]]
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* [[Amelanotic melanoma|Amelanotic]] or [[Hypomelanosis|hypomelanotic lesions]] or maybe [[nodular]] and desmoplastic subtypes
* Lesions may present as pink or red [[Macule|macules]], [[Plaque|plaques]], or [[nodules]], often with well-defined borders
* Often clinically confused with benign lesions
|
[[File:Melanoma 08.jpg|300px]]
|}

==References==
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