Molluscum contagiosum: The importance of early diagnosis and treatment
ABSTRACT Molluscum contagiosum is a viral infection that is becoming an increasing problem in sexually active individuals and in patients with human immunodeficiency virus. Although molluscum contagiosum lesions are generally self-limiting, it may take 6 months to 5 years for lesions to disappear. Furthermore, patients with weakened immune systems have increased difficulty in clearing lesions; therefore lesions typically persist for prolonged periods. Although there has been continued debate about whether molluscum contagiosum lesions should be treated or allowed to resolve spontaneously, many clinicians recommend treatment of genital molluscum contagiosum lesions to reduce the risk of sexual transmission, prevent autoinoculation, and increase patient quality of life. Treatment options for molluscum contagiosum include physician-administered and patient-administered therapies. Novel patient-administered treatment options allow administration in the privacy of a patient's home, providing added convenience and reducing patient embarrassment or stress. With the novel treatment opportunities currently available or in development, physicians are able to improve patient quality of life while providing patients with a convenient, well-tolerated, easily administered treatment regimen. This review summarizes the clinical diagnosis of molluscum contagiosum and provides a critical assessment of several current and emerging treatment options.
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Article: Esophageal Atresia with Proximal TEF[Show abstract] [Hide abstract]
ABSTRACT: Esophageal atresia with or without a tracheoesophageal fistula (TEF) is considered the most common congenital anomaly of the esophagus. Most cases are either esophageal atresia with distal TEF or pure esophageal atresia without a fistula. A gasless abdomen with a coiled nasogastric tube is sufficient evidence to diagnose pure esophageal atresia. Less than 1% of all cases of esophageal atresia have a concomitant proximal TEF. The presence of such anomaly can be suspected with the proximal esophageal stump is filled with air, or if a contrast proximal esophagogram is ordered and the fistulous tract identified. Intraoperatively a proximal TEF can be identified during bronchoscopy or more commonly while dissecting the proximal esophageal stump to obtain length for the anastomosis. Esophageal atresia is initially managed with a feeding gastrostomy to start gastric feeding and obtain a study to determine the gap that exists between the proximal and distal esophageal stumps. In the presence of a proximal TEF causing chronic aspiration of saliva the need for early esophageal continuity arises. The strategy can consist of ligating the TEF and doing an anastomosis under tension, bringing the proximal esophageal stump through an extrathoracic lengthening procedure or utilizing Foker technique of continuous proximal and distal lengthening with later anastomosis. In either cases the rate of ischemia, leak and stricture is high.
Article: Molluscum ContagiosumJournal of Cutaneous Pathology 02/1976; 3(4):204-5. DOI:10.1111/j.1600-0560.1976.tb00864.x · 1.56 Impact Factor