Q: 42 years old male recently with a history of HIV is admitted to ICU with COVID-19. On examination, noticed to have large firm, dome-shaped papules on the genitals. ID service made the diagnosis of Molluscum contagiosum virus (MCV) (Poxvirus). Which areas of the body are typically spared providing clues to the diagnosis? (select one)
A) palms and soles
B) axillae and popliteal fossae
Answer: A
Few risk factors for the Molluscum contagiosum virus in adults are sexual transmission, contact sports, inherited immunodeficiencies, and treatment with immunosuppressive drugs. It occurs as firm, dome-shaped papules. Pruritus may not be present. Characteristically, palms and soles are spared.
In non-sexual transmissions usual areas of involvement are trunk, axillae, antecubital popliteal fossae, and crural folds. It may cause conjunctivitis by touching. Lesions in sexually transmitted MCV are present in the groin, genitals, proximal thighs, and lower abdomen. In HIV and immunocompromised patients, lesions are usually large and called giant molluscum and are widespread in the body due to underlying systemic disease.
There are four genera of poxviruses
- Orthopox causes smallpox (variola), vaccinia (Indian-subcontinent), cowpox, monkeypox (west and central africa), and rabbitpox viruses
- Parapox causes orf, pseudocowpox, bovine papular stomatitis viruses
- Yatapox causes tanapox and yaba monkey tumor viruses
- Molluscipox causes molluscum contagiosum virus (MCV)
Chickenpox is not a true pox virus and is caused by the herpes virus varicella-zoster.
#ID
References:
1. Zorec TM, Kutnjak D, Hošnjak L, et al. New Insights into the Evolutionary and Genomic Landscape of Molluscum Contagiosum Virus (MCV) based on Nine MCV1 and Six MCV2 Complete Genome Sequences. Viruses 2018; 10.
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