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Molluscum contagiosum
Definition
Molluscum contagiosum is a viral skin infection that causes raised, pearl-like papules or nodules on the skin.
Causes
Molluscum contagiosum is caused by a virus that is a member of the poxvirus family. You can get the infection in a number of different ways.
This is a common infection in children and occurs when a child comes into direct contact with a lesion. It is frequently seen on the face, neck, armpit, arms, and hands but may occur anywhere on the body except the palms and soles.
The virus can spread through contact with contaminated objects, such as towels, clothing, or toys.
The virus also spreads by sexual contact. Early lesions on the genitalia may be mistaken for herpes or warts but, unlike herpes, these lesions are painless.
Persons with a weakened immune system (due to conditions such as AIDS) may have a rapidly worse case of molluscum contagiosum.
Symptoms
Typically, the lesion of molluscum begins as a small, painless papule that may become raised up to a pearly, flesh-colored nodule. The papule often has a dimple in the center. These papules may occur in lines, where the person has scratched. Scratching or other irritation causes the virus to spread in a line or in groups, called crops.
The papules are about 2 - 5 millimeters wide. There is usually no inflammation and subsequently no redness unless you have been digging or scratching at the lesions.
The skin lesion commonly has a central core or plug of white, cheesy or waxy material.
In adults, the lesions are commonly seen on the genitals, abdomen, and inner thigh.
Exams and Tests
Diagnosis is based on the appearance of the lesion and can be confirmed by a skin biopsy. The health care provider should examine the lesion to rule out other disorders and to determine other underlying disorders.
Treatment
In people with normal immune systems, the disorder usually goes away on its own over a period of months to years.
Persons with a comprimised immune system (such as AIDS) may have a rapidly worse case of molluscum contagiosum.
Individual lesions may be removed surgically, by scraping, de-coring, freezing, or through needle electrosurgery. Surgical removal of individual lesions may result in scarring.
Medications, such as those used to remove warts, may be helpful in removal of lesions, but can cause blistering that leads to temporary skin discoloration. Cantharidin, commonly called "beetle juice," is the most common solution used to treat the lesions. Tretinoin cream or imiquimod cream may also be prescribed.
Outlook (Prognosis)
Molluscum contagiosum lesions may persist from a few months to a few years. These lesions ultimately disappear without scarring, unless there is excessive scratching, which may leave marks.
Individual lesions usually disappear within about 2 - 3 months. Complete disappearance of all lesions generally occurs within about 6 - 18 months. The disorder may persist in immunosuppressed people.
Possible Complications
- Persistence, spread, or recurrence of lesions
- Secondary bacterial skin infections
When to Contact a Medical Professional
Call for an appointment with your health care provider if you have symptoms suggestive of molluscum contagiosum. Also call for an appointment with your health care provider if lesions persist or spread, or if new symptoms appear.
Prevention
Avoid direct contact with the skin lesions. Do not share towels with other people.
Avoiding sex can also prevent molluscum virus and other STDs. You can also avoid STDs by having a monogamous sexual relationship with a partner known to be disease-free.
Male and female condoms cannot fully protect you, as the virus can be on areas not covered by the condom. Nonetheless, condoms should still be used every time the disease status of a sexual partner is unknown. They reduce your chances of getting or spreading STDs. Use them with spermicide with nonoxynol 9.
See: Safer sex practices.
References
Cohen J, Powderly WG. Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2004:2053-2056.
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
