Herbert B. Allen, Rina M. Allawh, Shefali Ballal
Both the presence and impact of biofilms have proved to be ground breaking regarding early diagnosis and treatment in acute and chronic cutaneous, neurological and other internal diseases. Further, biofilms and the activation of the innate immune system have added clarity to the pathogenesis of those diseases. Our current observations are the first to demonstrate viral biofilms in skin disease; these observations are also the first to demonstrate intracellular biofilms in skin disease. We have observed these in lesions of Molluscum contagiosum (MC). The only previous observation of viral-induced biofilms has been with the HTLV-1 virus. The essential elements of a biofilm are extracellular polysaccharides (EPS) that form the bulk of the biomass, and amyloid fibers that form the proteinaceous infrastructure of the biofilm. Histopathology of skin lesions revealed positive periodic acid Schiff (PAS) and positive Congo red (CR) and crystal violet (CV) stains within MC lesions. The PAS stains the EPS while the Congo red and crystal violet stain the amyloid. Similar staining was absent both in controls and in surrounding skin; this is strong support for the hypothesis that the virus “hi-jacks” the cell’s DNA and makes “intra”cellular biofilms.