What is molluscum contagiosum?

Definition

Molluscum contagiosum is an infection of the skin. It is caused by the molluscum virus. In children, the most common areas affected are the
face, neck, arms, and hands. In adults, molluscum contagiosum is a
sexually
transmitted disease. In these cases the genitals and
surrounding skin are most commonly affected.

Causes

Contact with the virus causes this skin infection. This can occur with
skin to skin contact.

Risk Factors

Having skin-to-skin contact with an infected person is the main risk factor.
Other risk factors include indirect contact with an infected person through a
swimming pool or bath or by sharing towels or clothing, sexual contact with an
infected person, and having a weakened immune system (such as human immunodeficiency
virus infection and acquired immunodeficiency
syndrome). Broken skin increases the risk for getting the
disease and causes more severe symptoms.

Symptoms

Skin lesions are the main symptom. A person who experiences a similar skin lesion should not assume it is caused by this condition. These lesions may be caused by other health conditions.

Molluscum contagiosum skin lesions usually are small, dome-shaped bumps with dimpling in center; are painless, but may be itchy or tender; first appear translucent, pearly, or flesh-colored and later may turn gray and drain; and have a white or waxy substance in the center of the lesion. Multiple lesions usually are in groups. Common sites in children are the face, trunk, arms, and legs; in adults, common sites are the genitals, abdomen, and inner thigh. The lesions can last from several weeks to several years.

Screening and Diagnosis

Diagnosis is usually made based on the lesions.
Sometimes a biopsy will be taken. The sample will be looked at under a
microscope. The examining doctor may refer the patient to a dermatologist, a
specialist who focuses on skin conditions.

Treatment and Therapy

Left untreated, molluscum contagiosum usually resolves within six months. If untreated in people with human immunodeficiency virus infection, the lesions usually persist and spread indefinitely. The doctor may recommend removal of the lesions to prevent spreading and to avoid infecting others.

Treatment options include surgical removal of the lesions, which can be removed
by cutting them off the surface of the skin. With chemical treatment, chemicals
are placed directly on the lesions to remove them. Common chemical treatments
include podophyllin, cantharidin, phenol, silver nitrate, trichloracetic acid, and
iodine. Other treatments include cryotherapy, which uses cold to freeze
the lesions off of the skin (liquid nitrogen may be used for this treatment), and
retinoid or imiquimod cream, separately or in combination.

Prevention and Outcomes

Molluscum contagiosum is contagious. To reduce the risk of exposure to the virus, one should avoid contact with an infected person (this includes not sharing towels, clothing, baths, and pools) and avoid sexual contact with an infected person. To reduce the risk of spreading the disease, one should not touch the lesions (nor scratch them) and should wash hands promptly if he or she contacts the lesions.

Bibliography

Dohil, M. A., et al. “The Epidemiology of Molluscum Contagiosum in Children.” Journal of the American Academy of Dermatology 54, no. 1 (2006): 47-54.

Hanson, D., and D. G. Diven. “Molluscum Contagiosum.” Dermatology Online Journal 9, no. 2 (2003). Available at http://dermatology.cdlib.org/92/ reviews/molluscum/diven.html.

Theos, A. U., et al. “Effectiveness of Imiquimod Cream 5 Percent for Treating Childhood Molluscum Contagiosum in a Double-Blind, Randomized Pilot Trial.” Cutis 74, no. 2 (2004): 134-138, 141-142.