Proportion of molluscum contagiosum-associated outpatient visits among American Indian/Alaska Native persons by age for which concurrent skin conditions were recorded, 2001–2005.

<p>Total number of outpatient visits per age groups shown in parentheses. (†) Denotes skin conditions associated with loss of skin integrity (impetigo, diaper rash, unspecificed erythematos conditions, acne); (*) denotes skin conditions potentially associated with immune deficits (eczema/contact dermatitis, atopic dermatitis).</p

Characteristics of molluscum contagiosum-associated outpatient visits per patient and average annual incidence among American Indians and Alaska Natives by region, 2001–2005.

*<p>see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0005255#pone-0005255-g002" target="_blank">Figure 2</a> [map of US with different geographic regions highlighted].</p>†<p>Rate of outpatient visits involving molluscum contagiosum per 10,000 AI/AN population within the IHS healthcare system in the specified region (for individuals who had multiple clinic visits involving molluscum contagiosum during the study period, only the first annual visit is included).</p

Proportion of patients with molluscum contagiosum (MC) indicated as the principal diagnosis versus ancillary diagnosis, stratified by number of visits per patient among American Indian/Alaska Native persons, 2001–2005.

<p>Stripped bars represent proportion of patients with MC as the principal diagnosis; solid bars represent the proportion of patients with MC as an ancillary diagnosis. (*) 0.05 and 0.15% of patients experienced 8 or more MC-associated outpatient visits, respectively.</p

Molluscum contagiosum (MC)-associated outpatient visits among American Indian/Alaska Native persons by age (in years), 2001–2005.

<p>The average number of MC-associated IHS/tribal outpatient visits per year over the 5-year period is depicted along the left axis. Cumulative percent is shown along the opposing axis.</p

Number of molluscum contagiosum-associated outpatient visits for which a mechanical removal procedure was performed in the American Indian/Alaska Native population, 2001–2005.^*

*<p>Outpatient visits involving molluscum contagiosum among the AI/AN population within the IHS healthcare system.</p>†<p>Included under this procedure category are cauterization cryosurgery, fulguration and laser excision.</p

Proportion of molluscum contagiosum-associated outpatient visits occurring January–December among American Indian/Alaska Native persons, 2001–2005.

<p>Proportion of molluscum contagiosum-associated outpatient visits occurring January–December among American Indian/Alaska Native persons, 2001–2005.</p

Average annual rate of molluscum contagiosum-associated outpatient visits per 10,000 American Indian/Alaska Native persons by Indian Health Service region, 2001–2005.

<p>Southern Plains, 12.1; Southwest, 14.4; Northern Plains, West, 23.8; Northern Plains, East, 25.6; Alaska, 28.6; East, 31.1; West, 35.4. Texas is partitioned into three regions which fall under the jurisdiction of the Southwest, Southern Plains or East IHS regions.</p

Number of patients with incidence of molluscum contagiosum in the American Indian/Alaska Native population, 2001–2005.^*

*<p>Outpatient visits involving molluscum contagiosum among the AI/AN population within the IHS healthcare system.</p

Molluscum Contagiosum in a Pediatric American Indian Population: Incidence and Risk Factors

<div><p>Background</p><p>Molluscum contagiosum virus (MCV) causes an innocuous yet persistent skin infection in immunocompetent individuals and is spread by contact with lesions. Studies point to atopic dermatitis (AD) as a risk factor for MCV infection; however, there are no longitudinal studies that have evaluated this hypothesis.</p><p>Methods</p><p>Outpatient visit data from fiscal years 2001–2009 for American Indian and Alaska Native (AI/AN) children were examined to describe the incidence of molluscum contagiosum (MC). We conducted a case-control study of patients <5 years old at an Indian Health Service (IHS) clinic to evaluate dermatological risk factors for infection.</p><p>Results</p><p>The incidence rate for MC in children <5 years old was highest in the West and East regions. MC cases were more likely to have a prior or co-occurring diagnosis of eczema, eczema or dermatitis, impetigo, and scabies (p<0.05) compared to controls; 51.4% of MC cases had a prior or co-occurring diagnosis of eczema or dermatitis.</p><p>Conclusions</p><p>The present study is the first demonstration of an association between AD and MC using a case-control study design. It is unknown if the concurrent high incidence of eczema and MC is related, and this association deserves further investigation.</p></div

The frequency of dermatological risk factors in MC case patients at three time periods relative to the initial visit where MC was diagnosed - a) prior dermatological conditions (blue), b) co-occurring dermatological conditions (red), and c) a combination of prior and co-occurring conditions (green).

<p>MC cases include those from Facilities A and B.</p