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Definition
Molluscum contagiosum is a common, painless and usually harmless viral infection of the skin. It usually goes away after several months or few years.
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| | Epidemiology
It is common worldwide and accounts for about 1% of all skin disorders in the United States. It primarily affects children (boys more often than girls) and young adults. The incidence of molluscum contagiosum is increasing. | |
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Causes & Risk factors
It is caused by a Poxvirus.
Molluscum contagiosum is transmitted by direct contact, either person to person or by shared items, such as clothing, towels, and washcloths. MC can be spread by contact sports. Furthermore, if a person touches the rash and then another part of his or her body, it can cause spread to that area (known as autoinoculation). If the face is involved, shaving may cause it to spread. Although the contagiousness is generally low, it is not known for how long an infected person can transmit the virus. Poor hygiene and warm, moist climates encourage the spread of molluscum. Use of public or school swimming pools is associated with childhood infections.
Outbreaks have occurred in the following settings:
- swimming pools,
- wrestling matches,
- during surgery, by a surgeon with a hand lesion (sore),
- having tattoos (rare), and
- sexually: It is likely that genital lesions are sexually transmitted. Lesions develop within two to three months after exposure. Some doctors consider MC a sexually transmitted disease in adolescents and adults and recommend that people with genital MC be tested for other STDs. However, not all genital lesions in adults are sexually transmitted. Children with MC involving the genitals should be checked for possible sexual abuse. Nevertheless, genital lesions in children do not always mean that sexual abuse has occurred.
There have been no reports of catching MC from a contaminated toilet seat. Although theoretically possible, this means of transmission is probably very rare.
Adults are more often infected by molluscum through sexual contact and tend to have genital lesions. Children are most commonly affected with lesions appearing on the face, neck, arms, armpits, and hands. Patients with eczema and defective immunity like HIV infection may be more severely affected by molluscum - Giant molluscum. | |
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Symptoms
One or more small (1–5 mm) pink, white, or skin-colored, smooth, dome-shaped bumps, often with a tiny dot or depression in the center, occur in clusters and sometimes in a straight line from scratching and self-inoculation. In patients with a defective immune system, bumps can be larger. Most commonly, they are found on the face, eyelids, neck, underarms, and thighs. Adults often get them in the genital area. | |
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Tests
1) Microscopy: Examination of material from the boils
2) Biopsy of infected skin | |
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Treatment
1) Mild infections go away on their own. Care should be taken not to scratch infected areas.
2) Removal by freezing (cryosurgery), scraping (curettage), burning (electrocautery), or laser.
3) Application of chemicals (a strong acid or alkali) or Cantharone (an extract from a blister beetle).
4) Tretinoin cream(derived from vitamin A) or imiquimod (a prescription product also used to treat warts, another type of viral infection) podophyllin, imiquimod, cidofovir.
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Complications
Secondary bacterial infection
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Prevention
Good personal hygiene is a key factor in avoiding transmission of this disease.
1) MC is spread by close personal contact with infected people. Avoid skin-to-skin contact with others in order to prevent transmission.
2) Transmission has been shown to occur in children from swimming pools and in the sharing of baths, towels, gym equipment, and benches.
3) Because the rash can spread by autoinoculation (spread from one part of the body to another by touching the lesions), avoid scratching the lesions.
4) Because sexual transmission is common in adults, avoid sexual contact with infected people. It is unclear whether condoms are effective in preventing this disease.
Most cases go away by themselves in 6 to 12 months.
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