Bhatia Neal, Hebert Adelaide A, Del Rosso James Q
Dr. Bhatia is with Therapeutics Clinical Research in San Diego, California.
Dr. Hebert is with UTHealth McGovern Medical School in Houston, Texas.
J Clin Aesthet Dermatol. 2023 Aug;16(8 Suppl 1):S12-S17.
Despite its high global prevalence, molluscum contagiosum (MC) is not well understood outside of dermatology. Due to the potential self-limiting nature of MC, a common clinical approach in management is to wait for the papules to resolve spontaneously over several weeks to months, without medical intervention. However, this "watch and wait" approach increases risk of spreading the virus to others, extending the duration of the infection, and emergence of several psychosocial issues (e.g., anxiety, embarrassment, isolation). Molluscum contagiosum can be particularly challenging to treat in immunocompromised patients (e.g., human immunodeficiency virus [HIV], organ transplant recipients). This article reviews diagnostic characteristics and treatment options for MC, as well as associated risk factors and comorbidities. Treatment of immunocompromised individuals, in whom the risks of diffuse MC with persistence and spread are relatively high, is emphasized. The authors highlight the importance of actively treating the MC papules, as opposed to letting the virus "run its course" with no active intervention, with the goals of reducing the risk of spreading infection to others, shortening the duration of infection, and decreasing adverse psychosocial sequelae commonly associated with MC.
尽管传染性软疣在全球的患病率很高，但在皮肤科领域之外，人们对它的了解并不充分。由于传染性软疣具有潜在的自限性，临床上常见的处理方法是等待丘疹在数周或数月内自行消退，而不进行医学干预。然而，这种“观察等待”的方法会增加将病毒传播给他人、延长感染持续时间以及出现一些心理社会问题（如焦虑、尴尬、孤立）的风险。对于免疫功能低下的患者（如人类免疫缺陷病毒[HIV]感染者、器官移植受者），治疗传染性软疣可能特别具有挑战性。本文综述了传染性软疣的诊断特征、治疗选择以及相关的危险因素和合并症。重点强调了对免疫功能低下个体的治疗，这类患者发生弥漫性传染性软疣并持续存在和传播的风险相对较高。作者强调了积极治疗传染性软疣丘疹的重要性，而不是让病毒“自然发展”而不进行积极干预，目的是降低将感染传播给他人的风险、缩短感染持续时间以及减少通常与传染性软疣相关的不良心理社会后遗症。
