What are the key characteristics of Molluscum Contagiosum. How does this viral skin infection spread. What treatment options are available for Molluscum Contagiosum. Can Molluscum Contagiosum be prevented. Why is this condition more common in children and immunocompromised adults.

The Nature and Prevalence of Molluscum Contagiosum

Molluscum contagiosum is a widespread viral skin infection that primarily affects children, although adults with compromised immune systems can also contract it. This chronic condition is characterized by the appearance of raised, pearl-like bumps on the skin, which can persist for several months or even years. However, in most cases, the infection tends to resolve within 6 to 9 months.

The prevalence of molluscum contagiosum is significant, particularly among pediatric populations. Its ability to spread through direct contact makes it a common concern in schools, daycare centers, and households with young children. Understanding the nature of this infection is crucial for effective management and prevention strategies.

Why is Molluscum Contagiosum more common in children?

Children are more susceptible to molluscum contagiosum for several reasons:

• Frequent close contact with peers during play and activities
• Less developed immune systems compared to adults
• Higher likelihood of sharing personal items like towels or clothing
• Tendency to scratch or touch skin lesions, facilitating spread

These factors contribute to the higher incidence of molluscum contagiosum in children, making awareness and proper hygiene practices essential in pediatric settings.

Identifying Molluscum Contagiosum: Symptoms and Appearance

Recognizing the symptoms of molluscum contagiosum is crucial for early detection and management. The condition manifests through distinctive skin lesions with specific characteristics that set them apart from other skin conditions.

What are the typical features of molluscum contagiosum lesions?

Molluscum contagiosum papules have several distinguishing features:

• Size: Generally small, ranging from 2 to 5 millimeters in diameter
• Appearance: Firm, dome-shaped, and flesh-colored initially
• Texture: Smooth with a characteristic dimple or depression in the center
• Content: Contains a central core of white, waxy material
• Sensation: Usually painless, though some may experience itching
• Evolution: May soften over time and occasionally become red and drain

These lesions can appear on various parts of the body, including the face, trunk, and limbs in children, and the genitals, abdomen, and inner thighs in adults. The location and distribution of the papules can provide clues about the mode of transmission and help guide appropriate treatment strategies.

The Viral Culprit: Understanding the Cause of Molluscum Contagiosum

Molluscum contagiosum is caused by the molluscum contagiosum virus (MCV), a member of the poxvirus family. This highly contagious virus is responsible for the characteristic skin lesions associated with the infection.

How does the molluscum contagiosum virus spread?

The virus can be transmitted through several routes:

1. Direct skin-to-skin contact with an infected individual
2. Sexual contact with an infected partner
3. Autoinoculation through scratching or rubbing existing lesions
4. Contact with contaminated objects such as towels, clothing, or toys

Understanding these transmission pathways is crucial for implementing effective prevention strategies and minimizing the spread of the virus within communities. It’s important to note that the virus can survive on surfaces for extended periods, making proper hygiene and disinfection practices essential in managing outbreaks.

Diagnosis and Medical Assessment of Molluscum Contagiosum

Accurate diagnosis of molluscum contagiosum is essential for appropriate management and treatment. Healthcare providers typically rely on visual examination and clinical assessment to identify the condition.

What methods do doctors use to diagnose molluscum contagiosum?

Physicians employ several approaches to diagnose molluscum contagiosum:

• Visual inspection: The distinctive appearance of the papules often allows for a clinical diagnosis
• Dermoscopy: A non-invasive technique using a magnifying device to examine skin lesions in detail
• Skin biopsy: In uncertain cases, a small sample of the lesion may be removed for microscopic examination
• Polymerase chain reaction (PCR): A molecular test to detect the presence of the virus’s genetic material

While visual diagnosis is often sufficient, additional tests may be necessary in atypical presentations or when ruling out other conditions. For immunocompromised patients, a more thorough evaluation may be required to assess the extent of the infection and potential complications.

Treatment Approaches for Molluscum Contagiosum

The management of molluscum contagiosum often depends on the severity of the infection, the patient’s age, and their overall health status. While the condition can resolve spontaneously in individuals with healthy immune systems, treatment may be recommended to prevent spread and alleviate symptoms.

What are the primary treatment options for molluscum contagiosum?

Several treatment modalities are available for managing molluscum contagiosum:

1. Watchful waiting: Allowing the infection to resolve naturally, particularly in children
2. Physical removal: Curettage or cryotherapy to remove individual lesions
3. Topical medications: Application of agents like podophyllotoxin, imiquimod, or cantharidin
4. Oral treatments: Systemic medications for severe or widespread cases, especially in immunocompromised patients
5. Photodynamic therapy: Use of light-sensitive drugs and specific wavelengths of light to target lesions

The choice of treatment depends on factors such as the patient’s age, the extent of the infection, and personal preferences. It’s important to note that some treatments may cause temporary discomfort or scarring, and the benefits should be weighed against potential side effects.

Preventing the Spread of Molluscum Contagiosum

Prevention plays a crucial role in controlling the spread of molluscum contagiosum, particularly in settings where close contact is common. Implementing effective preventive measures can significantly reduce the risk of transmission and outbreaks.

How can individuals reduce their risk of contracting or spreading molluscum contagiosum?

Several strategies can help prevent the spread of molluscum contagiosum:

• Practice good hygiene: Regular handwashing and avoiding sharing personal items
• Cover lesions: Use clothing or bandages to prevent direct contact with affected areas
• Avoid scratching: Discourage touching or scratching lesions to prevent autoinoculation
• Manage underlying conditions: Treat eczema and other skin conditions that may increase susceptibility
• Safe sexual practices: Limit sexual partners and use protection, although condoms may not provide complete prevention
• Environmental cleaning: Regularly disinfect shared surfaces and objects in high-risk settings

Educating individuals, particularly children and caregivers, about these preventive measures is essential for controlling the spread of molluscum contagiosum in communities. Healthcare providers play a crucial role in disseminating accurate information and guiding patients on effective prevention strategies.

Molluscum Contagiosum in Special Populations

While molluscum contagiosum is generally a benign condition in healthy individuals, it can pose significant challenges for certain populations. Understanding how the infection affects different groups is crucial for tailoring management approaches and providing appropriate care.

How does molluscum contagiosum impact immunocompromised individuals?

For people with weakened immune systems, such as those with HIV/AIDS or undergoing immunosuppressive therapy, molluscum contagiosum can be more severe and persistent:

• Increased susceptibility: Higher risk of contracting the infection
• Widespread lesions: More extensive and numerous papules
• Chronic infection: Prolonged duration and resistance to standard treatments
• Atypical presentation: Lesions may be larger or have unusual appearances
• Increased complications: Higher risk of secondary bacterial infections

Managing molluscum contagiosum in immunocompromised patients often requires a more aggressive approach, including systemic treatments and close monitoring. Collaboration between dermatologists and infectious disease specialists may be necessary to provide comprehensive care for these individuals.

The Psychological Impact of Molluscum Contagiosum

While molluscum contagiosum is primarily a physical condition, its visible nature can have significant psychological effects on those affected, particularly children and adolescents. Understanding and addressing these emotional aspects is crucial for holistic patient care.

How can molluscum contagiosum affect a person’s mental well-being?

The psychological impact of molluscum contagiosum can manifest in several ways:

• Self-consciousness: Visible lesions may lead to embarrassment and reduced self-esteem
• Social isolation: Fear of stigma or contagion may cause individuals to withdraw from social activities
• Anxiety: Concerns about spreading the infection to others or recurring outbreaks
• Frustration: Prolonged duration of the condition and potential treatment discomfort
• Body image issues: Particularly in adolescents and adults with genital lesions

Healthcare providers should address these psychological aspects when managing molluscum contagiosum. Offering reassurance, providing accurate information, and if necessary, referrals to mental health professionals can help patients cope with the emotional challenges associated with the condition.

By understanding the multifaceted nature of molluscum contagiosum, including its physical manifestations, treatment options, preventive measures, and psychological impact, healthcare providers and patients can work together to effectively manage this common viral skin infection. Continued research and education are essential for improving outcomes and reducing the burden of molluscum contagiosum in various populations.

Molluscum Contagiosum: Causes, Symptoms, and Treatments

Written by WebMD Editorial Contributors

• What Is Molluscum Contagiosum?
• Skin and Molluscum Contagiosum
• Molluscum Contagiosum Symptoms
• Molluscum Contagiosum Causes
• Molluscum Contagiosum Diagnosis
• Molluscum Contagiosum Treatment
• Molluscum Contagiosum Prevention
• More

Molluscum contagiosum is a common viral skin infection. It most often affects children, but adults with weakened immune systems can get it, too.

Molluscum contagiosum causes either single or multiple raised, pearl-like bumps (papules) on the skin. It’s a chronic infection, so the bumps may last for a few months or a few years. But most cases get better in 6 to 9 months.

Molluscum contagiosum papules commonly appear on the face, trunk, and limbs of children and on the genitals, abdomen, and inner thighs of adults. The condition usually causes bumps that:

• Are generally painless but can itch
• Are small (2 to 5 millimeters in diameter)
• Have a dimple in the center
• Are firm, dome-shaped, and flesh-colored at first
• Become softer with time
• May turn red and drain over time
• Have a central core of white, waxy material

Molluscum contagiosum usually disappears on its own over a period of months to years if you have a healthy immune system. If you have AIDS or other conditions that affect the immune system, molluscum contagiosum can lead to widespread, chronic sores.

Molluscum contagiosum is caused by the molluscum contagiosum virus. It’s part of the pox virus family. You can spread molluscum contagiosum:

• Through direct contact with an infected person
• By having sexual contact with an infected person
• By rubbing or scratching the bumps

A diagnosis of molluscum contagiosum is based on the way the papule looks. If your doctor isn’t sure, they can confirm the diagnosis with a skin biopsy. They’ll remove a piece of skin to look at more closely. If they’re worried you might have other health problems, they can check for them, too.

Because molluscum contagiosum can go away on its own, you may not need treatment. But the doctor can remove individual bumps by scraping or freezing them. This procedure could leave a scar.

Topical medications (medications you put on your skin), like those used to remove warts, can also help remove the papules.

To prevent molluscum contagiosum, follow these tips:

• Avoid direct skin-to-skin contact with anyone who may have the condition.
• Treat eczema in children.
• Either don’t have sex or have a monogamous sexual relationship with someone who isn’t infected. (Male and female condoms don’t offer full protection. The virus can get to areas the condom doesn’t cover.)

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Candida auris fungal infections spreading in US at ‘alarming’ rate, says CDC

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  000Z”>22 March

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Image caption,

Candida auris infection

A deadly fungal infection that is hard to treat is spreading rapidly at an “alarming” rate, says the Centers for Disease Control and Prevention (CDC).

US cases nearly doubled in 2021 – from 756 to 1,471, says the CDC report.

Healthy people are not at risk from Candida auris, but those with weak immune systems – or using medical devices like ventilators or catheters – can suffer severe illness or die.

The majority of cases tested were immune to anti-fungal treatment.

For this reason the CDC has called it an “urgent antimicrobial resistance threat”. Many patients are in hospitals and elderly care homes.

It can spread from “contact with affected patients and contaminated surfaces or equipment”, the CDC said.

• What we know about the deadly fungus Candida auris

One in three patients with invasive infections dies, but it can be difficult to assess the exact role Candida auris played in vulnerable patients, said CDC epidemiologist Dr Meghan Lyman, the report’s lead author.

The most common symptoms are fever and chills that do not improve after treatment, according to the CDC.

Because most patients are already sick, it is sometimes hard to detect the fungal infection. Only a laboratory test can confirm an infection.

The infection was first reported in the US in 2016. The most rapid rise in cases was from 2020 to 2021, according to CDC data which was published in the Annals of Internal Medicine.

Another reason for concern was the increase of cases that became “resistant to echinocandins” which is the antifungal medicine most recommended for treatment of the infection.

The CDC attributes the rise in the number of cases reported to poor infection prevention at healthcare facilities, as well as enhanced screening efforts which have picked up on the surge in infections.

It also may have worsened due to strain on healthcare and public health systems during the Covid-19 pandemic.

In Mississippi, the state’s lead epidemiologist has identified a long-term acute-care facility to be at the centre of the outbreak.

“Unfortunately, multi-drug resistant organisms such as C. auris have become more prevalent among our highest risk individuals, such as residents in long-term care facilities,” Dr Paul Byers told NBC.

According to preliminary CDC data, there were 5 clinical cases of Candida auris in 2022. In more populous states like California and Texas, there were 359 and 160 cases, respectively.

Nationwide there were 2,377 clinical cases in 2022, which would be a marked rise from the 1,471 cases in 2021.

Dr Lyman, told CBS News the rise “emphasises the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control”.

Other countries have also been seeing an increase in Candida auris cases.

Last year, the World Health Organization included it on its list of “fungal priority pathogens”.

• United States

symptoms, signs and methods of treatment in Moscow at the Center for Surgery “SM-Clinic”

Fungal body of the paranasal sinuses: symptoms, signs and methods of treatment in Moscow at the Center for Surgery “SM-Clinic”

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Description of the disease

Fungal body of the paranasal sinus, or mycetoma, is an inflammatory disease of the paranasal sinuses provoked by fungi. Fungi of the genus Aspergillus are the most common pathogens.

The fungal body is formed by aspergillus colonies. Outwardly, it resembles a ball of 1 mm in diameter, consisting of an amorphous substance (like plasticine) of gray-black or gray-yellow color. Colonies are formed inside the paranasal sinus when a fungal spore enters its mucous membrane.

Every day a person comes into contact with a huge number of microorganisms, including fungi. Aspergillus spores are released into the air from decaying organic material. Under certain conditions, their concentration in the air can be very high. However, during normal functioning of the immune system, pathogens are not able to penetrate the body cavities. This is possible with serious immune disorders or with a decrease in the protective functions of the mucous membranes as a result of their damage.

According to morphological parameters, the fungal body of the sinus is one of the forms of mycotic sinusitis. The disease is characterized by a sluggish, often asymptomatic course, and is manifested by nonspecific signs. In advanced cases, fungal colonies fill the entire sinus and can even spread to other parts of the respiratory system, including the lungs.

The disease is associated with a low risk of complications. Only in the presence of severe concomitant pathologies and immune disorders, the pathogen can penetrate into the systemic circulation and spread throughout the body, which leads to the emergence of secondary foci. In severe situations, aspergillus is able to penetrate into the brain, provoking the formation of abscesses.

Species

Fungal sinusitis can occur in two forms:

• invasive, when pathogens penetrate tissues, destroying them;
• is non-invasive, while fungal colonies grow on the surface of tissues without penetrating deep (this is the type of fungal body).

Invasive fungal infections can develop at lightning speed, leading to serious consequences, or proceed chronically, gradually destroying tissues. The fungal body of the paranasal sinus, due to the oligosymptomatic course, may remain undiagnosed for several years of its existence.

Symptoms

At the beginning of development, the fungal body of the paranasal sinus does not manifest itself clinically. As the number of fungi increases, the activity of the inflammatory process increases. The patient may experience unilateral nasal congestion, discharge from one nostril may appear. The nature of the pathological secret can be different – watery, mucous, purulent or curdled.

With an increase in the size of the fungal body inside the sinus, pressure increases, which is manifested by uncomfortable sensations in the area of ​​​​the projection of the sinus and orbits. Symptoms of secondary sinusitis are possible – a feeling of fullness, purulent discharge, loss of smell, nasal voice, etc.

Causes

Fungal spores can be aerogenically spread and germinate in the sinuses when a person is in an environment in which the air contains high concentrations of the pathogen for a long time (for example, when working in grain, vegetable warehouses and other similar enterprises). Fungal sinusitis is most susceptible to people with a state of immunosuppression, which is observed in malignant tumors, HIV infection, exhaustion of the body, endocrine disorders, diabetes mellitus, etc.

Much more often, the fungal body of the sinus occurs after unsuccessful dental treatment of the upper teeth (from canines to 3 molars). The fact is that the periodontium of the tops of the roots of the teeth and the sinus mucosa are separated by a thin bone plate, and sometimes the roots of the teeth penetrate into the sinus cavity. During treatment at the dentist, the instrument can penetrate into the sinus. The perforation of the filling material into the sinus is not excluded, since often when fungal masses are removed, filling particles are found among them. The damaged mucosa cannot fully resist pathogens, resulting in favorable conditions for the development of fungal inflammation.

Diagnostics

Diagnosis of the fungal body of the sinus begins with a survey of the patient, collecting complaints and anamnesis. At the next stage, anterior and posterior rhinoscopy is performed, during which the condition of the mucous membranes of the nasal cavity is determined. Computed tomography is performed to assess the structure of the accessory sinuses. The fungal body is visualized on the pictures as a blackout focus with a granular structure, often with a radiopaque element in the center (filling). According to tomograms, it is possible to determine the localization and prevalence of education.

Methods of treatment

The fungal body of the paranasal sinus is treated exclusively by surgery. Antifungal drugs of local and systemic action are ineffective in mycetoma. First, an operation is performed to remove the fungal masses, then drug treatment is prescribed.

Surgical treatment

To remove the fungal body, a low-traumatic endoscopic maxillary sinusectomy is performed. During the intervention, an endoscope (a special instrument equipped with an optical system, a light bulb, and a channel for instruments) is inserted into the nasal cavity. At the first stage of the operation, the doctor expands the anastomosis (the natural opening through which the sinus communicates with the nasal cavity). Next, the endoscope is inserted into the sinus cavity, examined, and using miniature surgical instruments, the fungal body is carefully separated from the mucosa. At the end of the operation, the cavity is washed with antifungal agents.

After endoscopic sinusotomy, no scars remain on the face, because. all manipulations are performed through natural openings (nasal passages and sinus fistulas).

Conservative treatment

Performed only after surgery. Its task is to prevent the recurrence of the disease and to correct the identified violations.

Prevention

To avoid the development of fungal sinusitis, it is necessary to treat diseases of the upper respiratory tract in a timely manner, as well as to engage in general improvement of the body and strengthening the immune system. If you need to stay in an environment with a high concentration of fungal spores, you must use personal protective equipment.

Medical expert opinion

Rehabilitation

The rehabilitation period lasts 1-3 weeks, depending on the degree of damage to the sinus and the volume of the operation.

At the recovery stage, it is recommended to regularly carry out hygiene of the nasal cavity, to abandon intensive sports, excessive physical exertion and thermal procedures.

Question and answer

An otorhinolaryngologist deals with the diagnosis and treatment of pathology.

The disease is not considered particularly dangerous, but the presence of potentially pathogenic fungi in the body increases the risk of possible complications. Therefore, surgical intervention is recommended to be carried out in a planned manner as soon as possible after diagnosis.

No. It is necessary to eliminate fungal colonies surgically and then carry out treatment aimed at preventing relapse. Otherwise, at the end of drug therapy, the fungus will continue to develop further.

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Treatment of fungal diseases on the skin of the body

Recently, dermatologists in their practice are increasingly faced with progressive infectious diseases, the causative agents of which are pathogenic fungal microorganisms. Mycoses are a general group of diseases that are caused by fungi. They occur most often on the surface of the skin and are able to spread to nearby integumentary tissues, as well as spread with the bloodstream throughout the body at more severe stages of the development of the disease.

Fungal infections often have a number of similar symptoms, however, various types of fungi can be sources of pathology, so experts recommend that at the first noticeable signs of a fungal infection, consult a doctor who can accurately determine the cause and type of the disease by examining the patient and conducting the necessary tests.

The activity of fungi has a toxic effect on the human body, weakens the protective functions of the skin and the immune barrier, which can cause the development of other viral and bacterial diseases against the background of a fungal infection.

The treatment of diseases caused by pathogenic fungi is often complicated by the high resistance or resistance of these microorganisms to antifungal drugs and medicines, since over many years of fighting infectious diseases, fungi gradually developed insensitivity to certain active substances of fungicidal agents.

Skin fungus can be treated with topical agents and antifungal medicines, tablets and capsules. Doctors treat the use of internal medicines with great caution, preferring to fight the fungus of the skin with the help of external agents, since these drugs act on the fungus and its waste products locally, without spreading with the circulating blood throughout the body.

If the fungal disease progresses rather quickly and the effect of the use of external agents is not enough, dermatologists prescribe a course of combined fungicidal therapy, which includes the use of antifungal ointments, gels, drops, powders, suspensions, emulsions and lotions, as well as tablets and antibiotics, which are taken orally.

When choosing antifungal drugs, it is necessary to pay attention to the composition of the agent in order to exclude the occurrence of allergic reactions in response to the action of certain components of the drug, since contraindications and side effects from the use of fungicidal drugs can be not only general, but also individual.

The criteria for choosing a reliable agent against skin fungus are also the level of activity of the main component of the drug and the degree of its safety in case of interaction with the whole organism, and not just with a local focus of infection.

It is especially important to pay attention to the period of application of the antifungal agent, since the completion of the course of fungicidal therapy until the fungus of the skin is completely eliminated is fraught with a relapse of the infection, which will be much more difficult to fight due to the body weakened by long-term use of aggressive drugs.

Antifungal preparations often contain anti-inflammatory and antibacterial components. These drugs are more effective in eliminating a fungal infection than conventional fungicidal drugs, since effective treatment of a fungus always begins with the removal of the inflammatory process.

Specialists identify several main groups of drugs with basic active substances that are most often used to treat fungal diseases: amphotericin, terbinafine, itraconazole, ketoconazole and fluconazole.

These substances are able to inhibit the vital activity of the fungus of the skin, stop its development and prevent its spread throughout the body, and also effectively cope with the products of its reproduction, which are called mycelium. Mycelium remains on personal belongings, bedding and hygiene items of a person infected with a fungus even after a complete cure for fungal microorganisms parasitizing in the body, therefore, effective disposal of the fungus also includes antifungal sanitization of wardrobe items, towels and hygiene products for a patient with mycosis.

Dermatologists most often recommend terbinafine-based drugs such as Lamisil, Binafine and Terbizin. The most popular drugs for eliminating the fungus of the skin with itraconazole are Orungal and Itramikol. Effectively cope with the problem of the fungus of the upper layers of the skin Diflucan, Mikosist and Mikomax based on fluconazole and Mycozoral with ketoconazole in the composition. Griseofulvin, levorin ointment and Triderm are also successfully used to treat skin fungus.

In the case of a fungal infection spreading to the nail plates of the hands and feet, doctors recommend using milling drills for hardware grinding of the nail in order to ensure deeper penetration of fungicidal drugs into the lower layers of the skin. The nail can also be removed surgically, but the more popular and common way is to dissolve the nail plate with the help of chemicals.

Skin fungus can also be fought with traditional therapy, which had many methods to eliminate fungal infections of the skin even before the advent of modern methods of treatment.

Wine vinegar is good at stopping growth and eliminating skin fungus, especially in the early stages of infection. It is necessary to make wine vinegar baths daily for 14-16 days; instead of baths, you can also use lotions or cotton balls that are soaked in wine vinegar.

An excellent antifungal tool at hand is a 1:1 solution of iodized salt and soda, the solution must be diluted to avoid damage to the epidermis and soften the surface layers of the skin. Rinse with cold water and keep for at least 30 minutes.

As a fungicidal folk remedy, you can also use ground coffee, which is poured with warm water and allowed to infuse for 5-10 minutes. The coffee solution must be without sediment, applied to the area affected by the fungus daily for at least a week for 15-20 minutes, rinsed with water with the addition of vinegar. Coffee has not only pronounced antifungal properties, but is also able to relieve pain and relieve signs of an inflammatory reaction, acting locally.

Lemon juice and onion juice fight well against fungal microorganisms, inhibiting their vital activity and preventing the spread of their reproduction products in the environment. To get rid of parasitic fungi, it is necessary to rub the focus of infection on the skin with lemon or onion juice 2 times a day, they can also be mixed, add garlic juice and butter, apply as an antifungal mask every 2 days, rinse with cold water with the addition of aromatic verbena oils.

An infusion of medicinal plants and herbs will help to more effectively eliminate the consequences of the destructive activity of the fungus of the skin and return the skin to normal. To prepare an antifungal decoction, mix oak bark, horsetail, calendula and blackberries, pour hot water and infuse in a cold, dark place for at least a week, then strain the solution and use it as a fungicidal lotion daily for at least a month.

Coniferous plants, due to the high concentration of phytoncides, are also able to kill the fungus and effectively cleanse the skin from the consequences of its parasitism.