Molluscum contagiosum natural history, complications and prognosis: Difference between revisions

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{{CMG}}; {{AE}}{{MIR}}
{{CMG}}; {{AE}}{{MIR}}
== Overview ==
== Overview ==
If left untreated, most of the patients with molluscum contagiosum may resolve the lesions spontaneously. Common complications of molluscum contagiosum include [[scarring]], [[conjunctivitis]], inflammatory reaction to molluscum contagiosum anigen and rarely [[Gianotti-Crosti syndrome|Gianotti-Crosti]] like eruptions. Prognosis is generally good.


:If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3]. Common complications of [disease name] include [complication 1], [complication 2], and [complication 3]. Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
:OR
:Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary.  However, the prognosis is generally regarded as poor/good/excellent.
*'''Additional Sentences:'''
:[Disease/malignancy] is associated with a 5 year survival rate of [#]%.
:The presence of metastasis is associated with a particularly poor prognosis among patients with [disease/malignancy]. The 5 year event free survival rate is less than [#]%.
:The [Subtype of disease or malignancy] is associated with the most favorable prognosis.
:The prognosis varies with the [characteristic] of tumor: [subtype of disease/malignancy] have the most favorable prognosis.
==Natural History==
==Natural History==
*The natural history of disease details how the disease progresses without treatment.
*The symptoms of molluscum contagiosum usually develop 2 to 7 weeks after exposure but may range from 1 week to 6 months, with a mean of 6 weeks.
*Here are a few template sentences you can use: "The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___. The symptoms of (disease name) typically develop ___ years after exposure to ___. Without treatment, the patient will develop symptoms of ___, which will/ may eventually lead to ___.
*Molluscum contagiosum initially presents with [[rash]] and [[pruritis]].  
*The average incubation period ranges from 2 to 7 weeks. In a minority of cases, disease persists for three to five years. <ref name="pmid16445494">{{cite journal |vauthors=Brown J, Janniger CK, Schwartz RA, Silverberg NB |title=Childhood molluscum contagiosum |journal=Int. J. Dermatol. |volume=45 |issue=2 |pages=93–9 |year=2006 |pmid=16445494 |doi=10.1111/j.1365-4632.2006.02737.x |url=}}</ref><ref name="pmid23545377">{{cite journal |vauthors=Butala N, Siegfried E, Weissler A |title=Molluscum BOTE sign: a predictor of imminent resolution |journal=Pediatrics |volume=131 |issue=5 |pages=e1650–3 |year=2013 |pmid=23545377 |doi=10.1542/peds.2012-2933 |url=}}</ref><ref name="pmid21214122">{{cite journal |vauthors=Lee R, Schwartz RA |title=Pediatric molluscum contagiosum: reflections on the last challenging poxvirus infection, Part 1 |journal=Cutis |volume=86 |issue=5 |pages=230–6 |year=2010 |pmid=21214122 |doi= |url=}}</ref>
*Molluscum contagiosum is a self limited disease that usually resolves without treatment.
*Occasionally, the disease may persist for three to five years. <ref name="pmid16445494">{{cite journal |vauthors=Brown J, Janniger CK, Schwartz RA, Silverberg NB |title=Childhood molluscum contagiosum |journal=Int. J. Dermatol. |volume=45 |issue=2 |pages=93–9 |year=2006 |pmid=16445494 |doi=10.1111/j.1365-4632.2006.02737.x |url=}}</ref><ref name="pmid23545377">{{cite journal |vauthors=Butala N, Siegfried E, Weissler A |title=Molluscum BOTE sign: a predictor of imminent resolution |journal=Pediatrics |volume=131 |issue=5 |pages=e1650–3 |year=2013 |pmid=23545377 |doi=10.1542/peds.2012-2933 |url=}}</ref><ref name="pmid21214122">{{cite journal |vauthors=Lee R, Schwartz RA |title=Pediatric molluscum contagiosum: reflections on the last challenging poxvirus infection, Part 1 |journal=Cutis |volume=86 |issue=5 |pages=230–6 |year=2010 |pmid=21214122 |doi= |url=}}</ref>
*In rare cases of eye involvement are left untreated, chronic [[conjunctivitis]] or [[Keratoconjunctivitis|keratoconjunctiviti]]<nowiki/>s may progress to [[Visual disturbance|visual disturbance.]]
==Complications==
==Complications==
*Using lists can be helpful for describing this section.
Complications that can develop as a result of molluscum contagiosum is skin scarring (which usually may happen after spontaneous resolution), chronic [[conjunctivitis]] or [[Keratoconjunctivitis|keratoconjunctivitis,]] and rarely [[Gianotti-Crosti syndrome|Gianotti-Crosti]] like eruptions. Inflammatory reactions to molluscum contagiosum [[antigen]], including the previously underrecognized GCLR, has been reported.
*You can use these template sentences;
*[[Scarring]] may be associated with [[Eczematous Scaling|eczematous]] patches or [[plaques]] surrounding molluscum contagiosum lesions.
**"Complications that can develop as a result of (disease name) are ___ (describe in list form)".
*[[Gianotti-Crosti syndrome|Gianotti-Crosti]] syndrome is characterized by distinct, self-limiting, [[erythematous]], symmetrical, [[Papulovesicular acrolocated syndrome|papulovesicular]] eruptions mainly distributed on the [[extremities]], [[buttocks]] and [[face]] in young children<ref name="pmid22911012">{{cite journal |vauthors=Berger EM, Orlow SJ, Patel RR, Schaffer JV |title=Experience with molluscum contagiosum and associated inflammatory reactions in a pediatric dermatology practice: the bump that rashes |journal=Arch Dermatol |volume=148 |issue=11 |pages=1257–64 |year=2012 |pmid=22911012 |doi=10.1001/archdermatol.2012.2414 |url=}}</ref><ref name="pmid26751677">{{cite journal |vauthors=Babu TA, Arivazhahan A |title=Gianotti-Crosti Syndrome following immunization in an 18 months old child |journal=Indian Dermatol Online J |volume=6 |issue=6 |pages=413–5 |year=2015 |pmid=26751677 |pmc=4693355 |doi=10.4103/2229-5178.169713 |url=}}</ref>.
**"Complications that can develop as a result of the treatment of (disease name) are ___ (describe in list form).
**Next to each complication, provide a brief one sentence description detailing the complication.
*For an example of the complications section in a natural history, complications and prognosis page, click [[Pericarditis natural history#complications|here]].
*MC in healthy people is a self-limiting disease, but it will take about 18 months to resolve by its own. Even though it is self-limiting, it is spreading nature, for cosmetic reasons and to accelerate healing, treatment is called for.
*MC is a treatable cause of chronic conjunctivitis or keratoconjunctivitis.
*Gianotti-Crosti like eruptions have been reported in patients with molluscum contagiosum. In one large retrospective study, this phenomenon was diagnosed in 5 percent.  Gianotti-Crosti like reactions may portend a higher likelihood of forthcoming clinical improvement. Molluscum dermatitis, inflamed MC lesions, and Gianotti-Crosti syndrome-like reactions (GCLRs) occurred in the same order.<ref name="pmid22911012">{{cite journal |vauthors=Berger EM, Orlow SJ, Patel RR, Schaffer JV |title=Experience with molluscum contagiosum and associated inflammatory reactions in a pediatric dermatology practice: the bump that rashes |journal=Arch Dermatol |volume=148 |issue=11 |pages=1257–64 |year=2012 |pmid=22911012 |doi=10.1001/archdermatol.2012.2414 |url=}}</ref>
* Inflammatory reactions to MC, including the previously underrecognized GCLR, are common. Treatment of molluscum dermatitis can reduce spread of MC via autoinoculation from scratching, whereas inflamed MC lesions and GCLRs reflect cell-mediated immune responses that may lead to viral clearance.
 
==Prognosis==
==Prognosis==
*This section should detail the prognosis of the disease, both treated and untreated.
The prognosis of molluscum contagiosum is good even without treatment. Sometimes, molluscum contagiosum will result in [[scarring]]. The presence of [[atopic dermatitis]] is associated with a particularly poor prognosis and higher chance of [[Scarring|scar development]] among patients with molluscum contagiosum.
*Here are some template sentences; "The prognosis of (disease name) is poor/good with treatment. Without treatment, (disease name) will result in ___. (Disease name) is associated with a 1/5/10 year mortality of __ among patient with ______ (for example high grade lesions). The presence of ___ is associated with a particularly poor prognosis among patients with (disease name).
*For an example of a prognosis section within a natural history, complications and prognosis page, click [[Pericarditis natural history#prognosis|here]].
 
One in ten children with molluscum contagiosum is likely to have a substantial effect on their quality of life and therefore treatment should be considered for some children, especially those with many lesions or who have been identified as having a severe effect on quality of life. Patients with molluscum contagiosum and their parents need to be given accurate information about the expected natural history of the disorder. Our data provide the most reliable estimates of the expected time to resolution so far and can be used to help set realistic expectations.<ref name="pmid25541478">{{cite journal |vauthors=Olsen JR, Gallacher J, Finlay AY, Piguet V, Francis NA |title=Time to resolution and effect on quality of life of molluscum contagiosum in children in the UK: a prospective community cohort study |journal=Lancet Infect Dis |volume=15 |issue=2 |pages=190–5 |year=2015 |pmid=25541478 |doi=10.1016/S1473-3099(14)71053-9 |url=}}</ref>
 
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 15:57, 24 July 2017

Molluscum contagiosum Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Molluscum contagiosum from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria

History and Symptoms

Physical Examination

Laboratory Findings

X ray

Ultrasound

CT Scan

MRI

Other Imaging Studies

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Overview

If left untreated, most of the patients with molluscum contagiosum may resolve the lesions spontaneously. Common complications of molluscum contagiosum include scarring, conjunctivitis, inflammatory reaction to molluscum contagiosum anigen and rarely Gianotti-Crosti like eruptions. Prognosis is generally good.

Natural History

  • The symptoms of molluscum contagiosum usually develop 2 to 7 weeks after exposure but may range from 1 week to 6 months, with a mean of 6 weeks.
  • Molluscum contagiosum initially presents with rash and pruritis.
  • Molluscum contagiosum is a self limited disease that usually resolves without treatment.
  • Occasionally, the disease may persist for three to five years. [1][2][3]
  • In rare cases of eye involvement are left untreated, chronic conjunctivitis or keratoconjunctivitis may progress to visual disturbance.

Complications

Complications that can develop as a result of molluscum contagiosum is skin scarring (which usually may happen after spontaneous resolution), chronic conjunctivitis or keratoconjunctivitis, and rarely Gianotti-Crosti like eruptions. Inflammatory reactions to molluscum contagiosum antigen, including the previously underrecognized GCLR, has been reported.

Prognosis

The prognosis of molluscum contagiosum is good even without treatment. Sometimes, molluscum contagiosum will result in scarring. The presence of atopic dermatitis is associated with a particularly poor prognosis and higher chance of scar development among patients with molluscum contagiosum.

References

  1. ↑ Brown J, Janniger CK, Schwartz RA, Silverberg NB (2006). "Childhood molluscum contagiosum". Int. J. Dermatol. 45 (2): 93–9. doi:10.1111/j.1365-4632.2006.02737.x. PMID 16445494.
  2. ↑ Butala N, Siegfried E, Weissler A (2013). "Molluscum BOTE sign: a predictor of imminent resolution". Pediatrics. 131 (5): e1650–3. doi:10.1542/peds.2012-2933. PMID 23545377.
  3. ↑ Lee R, Schwartz RA (2010). "Pediatric molluscum contagiosum: reflections on the last challenging poxvirus infection, Part 1". Cutis. 86 (5): 230–6. PMID 21214122.
  4. ↑ Berger EM, Orlow SJ, Patel RR, Schaffer JV (2012). "Experience with molluscum contagiosum and associated inflammatory reactions in a pediatric dermatology practice: the bump that rashes". Arch Dermatol. 148 (11): 1257–64. doi:10.1001/archdermatol.2012.2414. PMID 22911012.
  5. ↑ Babu TA, Arivazhahan A (2015). "Gianotti-Crosti Syndrome following immunization in an 18 months old child". Indian Dermatol Online J. 6 (6): 413–5. doi:10.4103/2229-5178.169713. PMC 4693355. PMID 26751677.
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