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Molluscum contagiosum

Von der pädiatrischen Dermatologie zur sexuell übertragbaren Infektion

Mollusca contagiosa

From paediatric dermatology to sexually transmitted infection

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Zusammenfassung

Mollusca contagiosa (MC) sind eine häufig auftretende, durch das Molluscum-contagiosum-Virus verursachte Hautinfektion, sie kann Kinder und Erwachsene betreffen. Sie ist relativ häufig bei 1- bis 5-Jährigen und kann an fast allen Körperstellen auftreten. Bei Erwachsenen gelten MC als sexuell übertragbare Infektion (STI). Das Molluscum-contagiosum-Virus kann direkt von Mensch zu Mensch übertragen werden oder durch Autoinokulation. Bei Erwachsenen finden sich MC typischerweise in der Genitalregion. Extragenitaler Befall tritt häufiger auf unter Immunsuppression, besonders bei HIV-Infektion. Bei HIV-positiven Patienten können MC als Teil eines immunrekonstitutionellen inflammatorischen Syndroms (IRIS) verstanden werden. Bei Kindern sind vermutlich beide Geschlechter gleich häufig betroffen, bei Erwachsenen scheint die Prävalenz unter Männern höher zu sein. Hinsichtlich einer Behandlung bestehen zwar Kontroversen, sie kann aber sehr hilfreich sein bei der Prävention. Bisher gibt es keine kausale Therapie, die meisten Behandlungsoptionen sind mechanischer Art, andere sind nicht hinreichend evidenzbasiert. Besondere Beachtung sollte einem extragenitalen Befall bei Erwachsenen geschenkt werden, dann sollte ein HIV-Test empfohlen werden. Zur Prävention von Übertragung und Autoinokulation sollten sowohl Kinder als auch Erwachsene mit MC angehalten werden, Hautkontakt und Kratzen zu vermeiden. Erwachsene MC-Patienten sollten einem Screening auf andere sexuell übertragbare Infektionen unterzogen und entsprechend beraten werden.

Abstract

Molluscum contagiosum (MC) is a common cutaneous infection caused by the molluscipox virus (MCV) and can affect both children and adults. Molluscum contagiosum is relatively frequent in children aged 1-5 years old and can be localized almost anywhere on the body, but in adults it is regarded as a sexually transmitted infection (STI). MCV can be transmitted directly from person to person or by autoinoculation. MC in adults characteristically involves the genital area but extragenital appearance can be more typically seen in patients with immunosuppressive conditions, especially in HIV/AIDS. The onset of MC in HIV-positive individuals can be regarded as a part of the immune reconstitution inflammatory syndrome (IRIS). MC probably affects both sexes equally in children, whereas it seems that in adults the incidence is more prevalent in males. Therapy is controversial but may be considerably beneficial in preventing transmission or autoinoculation. At present there is no aetiological treatment of MC and most treatment options are mechanical sometimes causing discomfort or are not sufficiently evidence-based. Attention should be given to the extragenital site of involvement in adults and HIV testing should be recommended. Both children and adults with MC should be educated to avoid scratching and skin contact with others to prevent transmission and autoinoculation. Adult patients with MC should be carefully screened for other STIs and appropriately counseled.

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Authors and Affiliations

  1. University Department of Dermatology and Venereology, Zagreb University Hospital and Medical School of Zagreb University, Šalata 4, 10000 , Zagreb, Kroatien

    M. Skerlev M.D., Ph.D & K. Husar M.D., M.A.

  2. Department of Pathophysiology, Medical School of Zagreb University, Zagreb, Kroatien

    M. Sirotković-Skerlev

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  1. M. Skerlev M.D., Ph.D
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  2. K. Husar M.D., M.A.
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  3. M. Sirotković-Skerlev
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Correspondence to M. Skerlev M.D., Ph.D.

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Skerlev, M., Husar, K. & Sirotković-Skerlev, M. Molluscum contagiosum. Hautarzt 60, 472–476 (2009). https://doi.org/10.1007/s00105-009-1772-7

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