Edwards S, Boffa M J, Janier M, Calzavara-Pinton P, Rovati C, Salavastru C M, Rongioletti F, Wollenberg A, Butacu A I, Skerlev M, Tiplica G S
ICaSH, CCS, Bury St Edmunds, UK.
Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta.
J Eur Acad Dermatol Venereol. 2021 Jan;35(1):17-26. doi: 10.1111/jdv.16856. Epub 2020 Sep 2.
Molluscum contagiosum is a benign viral epidermal infection associated with high risk of transmission. The guideline is focused on the sexually transmitted molluscum contagiosum. The diagnosis is clinical with characteristic individual lesions, termed 'mollusca', seen as dome-shaped, smooth-surfaced, pearly, firm, skin-coloured, pink, yellow or white papules, 2 - 5 mm in diameter with central umbilication. Dermoscopy may facilitate diagnosis. Therapeutic options are numerous, including physical treatments (cautery, curettage and cryotherapy), topical chemical treatments (e.g. podophyllotoxin and imiquimod) or waiting for spontaneous resolution in immunocompetent patients. In pregnancy, it is safe to use physical procedures (e.g. cryotherapy). Immunosuppressed patients develop severe and recalcitrant molluscum lesions that may require treatment with cidofovir, imiquimod or interferon. Patients with molluscum contagiosum infection should be offered to be screened for other sexually transmitted infections.
传染性软疣是一种良性病毒性表皮感染,具有高传播风险。本指南聚焦于性传播的传染性软疣。诊断主要依靠临床特征,可见特征性的单个损害,称为“软疣小体”,表现为圆顶状、表面光滑、珍珠样、质地坚实、肤色、粉红色、黄色或白色丘疹,直径2 - 5毫米,中央有脐凹。皮肤镜检查可能有助于诊断。治疗方法众多,包括物理治疗(烧灼、刮除和冷冻疗法)、局部化学治疗(如鬼臼毒素和咪喹莫特),或等待免疫功能正常的患者自行消退。在孕期,采用物理方法(如冷冻疗法)是安全的。免疫抑制患者会出现严重且顽固的软疣损害,可能需要用西多福韦、咪喹莫特或干扰素进行治疗。患有传染性软疣感染的患者应接受其他性传播感染的筛查。