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Poxvirus (Molluscum)

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Key Points

  • Poxvirus
    • Key Viruses
      • Molluscum contagiosum
      • Smallpox (variola)
        • eradicated world-wide by live attenuated vaccine
      • Cowpox - milkmaid blisters
    • Characteristics
      • DNA virus
        • Replicates in cytoplasm
          • Carries its own DNA-dependent RNA polymerase
          • Only DNA virus to not replicate in nucleus
        • Double stranded
        • Linear chromosome
        • Largest DNA virus
      • Enveloped
    • Transmission
      • Skin-to-skin contact
        • May be transmitted by sexual contact, shared bath towels, contact sports
    • Presentation: Molluscum
      • Dome-shaped pearly papule with central umbilication
      • Affects immunocompetent children or immunocompromised adults
        • Often seen in HIV in adults (30% of patients)
        • Aging thought to confer immunity
    • Diagnosis
      • Molluscum bodies seen on biopsy of lesion
        • Large keratinocytes with granular eosinophilic cytoplasmic inclusions
          • contains accumulated virions
    • Treatment
      • Usually not indicated; disease is self-limiting