Case 5: Molluscum Contagiosum

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You answered:

	Recent data have shown that valacyclovir (Valtrex) is a highly effective treatment for molluscum in HIV-infected persons.

This answer is incorrect. There are no data to suggest that valacyclovir has clinical utility in treating molluscum contagiosum. The drug cidofovir (Vistide) is the only antiviral compound convincingly shown to have direct activity against the poxvirus that causes molluscum contagiosum. Treatment with antiretroviral medications often causes an improvement in molluscum, but this presumably occurs as a result of enhanced immune function, not direct antiviral activity.

	The diagnosis of molluscum contagiosum in this patient is probably wrong because molluscum lesions almost never develop on the face of HIV-infected persons.
	Molluscum contagiosum is caused by human papillomavirus (HPV) type 6.
	Although molluscum contagiosum can result in disfiguring skin lesions in HIV-infected persons with advanced immune suppression, these individuals do not develop systemic complications from molluscum.

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