Part 2

Molluscum Contagiosum. Warts.

Presented by Prof. Hala Aly Ibrahim,MD

Molluscum contagiosum
Viral disorder of the skin and mucous membranes characterized by discrete, glistening, pearly white umbilicated

papules which may
show a central pore,

The causative agent is a DNA virus of the pox virus group. Seen most frequently in children between the ages of 3 and 16 , this disorder my appear at any age.

The lesions are both contagious and auto-inoculable. auto-

In children they are generally located on the face, trunk, extremities

(especially in the axillae), axillae), and on the mucous membranes of the lips, tongue and buccal mucosa.

is In adults, involvement of the pubic, genital and perineal areas is common.

*Pear-shaped acanthosis. *Molluscoid bodies (round,eosinophilic anuclear cells).

€ Curettage € ELectrocautery € Needle

transfixion € Cryotherapy € Chemical cautery(TCA,Carbolic acid) € Immune-modulator:Imiquimod

Benign epithelial hyperplasia caused by infection with the papilloma virus of the papova group.HPV has more than 100 types.

Koilinocyte

Early verrucae are usually round, discrete,papule

s
and size.

skin-colored, pinpoint in

With time they grow to larger yellowish, grayish-black or brown lesions with a roughened papillomatous surface.

€

€ €

Verrucae spread by direct or indirect contact. IP days-2 yrs. Since local trauma promotes inoculation of the virus, most warts are seen on the fingers, hands, and elbows,

€ along

the perionychial folds, or on the plantar surfaces of the feet.

€A. Non-venereal

warts.

€B. Venereal

warts.

1.Verruca vulgaris

3.Verruca digitiform

Verruca plana

Koebner s Phenomenon

€ Located € Painful. € Single

at pressure points.

or multiple(mosiac). € Leveled with sole skin. € D.D corn, callosities. 

Sexually

transmitted form of anogenital warty growth caused by the human  papilloma viruses.

flat warts are probably onchogenic (type 16 18 31)

Large cauliflower warts are commonly non-onchogenic (type 6,11) non-

General

Transmission of infection(self,others) Recurrence Secondary bacterial infection.
Specific
certain types of HPV are precancerous

CIN,VIN(HPV 16-18) Laryngeal papillomata
N.B A pregnant lady with V.warts should be delivered by CS.

€ A. Destructive

measures.

€ B. Immunomodulatory

measures.

€

1.Physical: 2.Chemical cautery:

*Electrocautery. *cryotherapy. *LASER. *Surgical excision.

* TCA,Glacial acetic acid. *Formalin sol. ,Salisylic acid Powder(planter warts) *Podophylline 25%,podophyllotoxin(genital warts).

N.B podophylline is contraindicated in pregnancy(IU foetal death)

Trials to stimulate the CMI in resistant warts, immunosupressed pts.
€ Interferon. € Levamisole. € 5-Flurouracil € Imiquimod

(acts through stimulation of T-helper cells via activation of pathogen recognition receptors)

Thanks for your attention, Good luck, Prof. Hala Aly Ibrahim,MD.

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