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.
In children they are generally located
on the face, trunk, extremities
(especially in the
axillae), and
on the mucous
membranes of the
lips, tongue
and buccal
mucosa.
In adults, involvement of the
is 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,papules
skin-colored, and
pinpoint in size.
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 at pressure points.
 Painful.
 Single 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)
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:
*Electrocautery.
*cryotherapy.
*LASER.
*Surgical excision.
2.Chemical cautery:
* 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.