Molluscum Contagiosum: Skin Infection

What Is Molluscum Contagiosum?

You are not the only person who has ever experienced painless, insignificant pimples that refuse to go away. Many people are shocked to hear that molluscum contagiosum, a little-known skin condition, could be the origin of these apparently innocuous lesions.

Most patients describe molluscum contagiosum in adults, a sexually transmitted disease (STD), as asymptomatic pimples over the genitalia. The Molluscum contagiosum virus causes it, a DNA (deoxyribonucleic acid) virus of the poxvirus family. It spreads by close contact, commonly with children, the immunocompromised, and increasingly younger adults, in the latter as a sexually transmitted disease. The incidence peaks at the ages of five and ten.

Causes Molluscum Contagiosum

The molluscum contagiosum virus is a type of poxvirus. Direct skin-to-skin contact, including intercourse, or contact with contaminated toys, clothes, or towels, can transmit it. By touching or scratching the sores, the molluscum contagiosum virus can potentially spread to other areas of the body—a process called auto-inoculation.

How Molluscum Contagiosum Spreads?

Molluscum contagiosum is primarily transmitted through direct contact. Touching the infected area transmits the virus from one person to another. In the case of children, transmission through direct contact is seen, whereas in HIV (human immunodeficiency virus)-infected young adults, transmission is by sexual contact.

Persons involved in sports also risk contracting the disease by touching the ball or other equipment touched by an infected person in bare hands, as the virus can stay on surfaces that have been touched by an infected person. And so, the spread of the virus is also possible by sharing personal items, toys, etc.

Molluscum contagiosum stages can spread from one part of the body to another by touching, scratching, or shaving the lesion with the hands and touching other parts of the body with the same infected hands.

Who Develops Molluscum Contagiosum?

• Most victims of molluscum contagiosum are babies and young children under ten years old. It is more common in populated areas and warm regions. Adults and adolescents are not affected as frequently. When putting lotion on or while bathing, parents frequently see these pimples for the first time. They can become alarmed because they think it is a wart or another skin issue.

• Due to weaknesses in the skin barrier, molluscum contagiosum appears to be more frequent and persists longer in children affected with atopic dermatitis (itchy and inflamed skin). It can be quite common and troublesome in people who have the human immunodeficiency virus or other weakened immune systems.

Symptoms: Molluscum Contagiosum

• After a variable incubation period (14 days to six months), the disease begins with molluscum contagiosum. Typical lesions start as small whitish papules and gradually enlarge to become characteristic shiny, pearly white, hemispherical, dome-shaped, five to 10 mm (millimeters) umbilicated papules with central depression.

• Lesions are primarily multiple, sometimes single, or a few lesions may localize anywhere on the body, depending on their mode of transmission. For example, on the face and limbs of children and the genitals of adults, in case of sexual transmission.

• The atypical presentation can occur over the scalp, lips, palms, and soles and is mistaken for verruca vulgaris (benign wart).

• In HIV infection or AIDS (acquired immunodeficiency syndrome) patients, this infection is common. It is often a marker of advanced disease and may exhibit multiple and extensive lesions. The morphology of which may not remain as distinctive as in the immunocompetent.

• Molluscum contagiosum symptoms are giant lesions or grape-like clusters of multiple small lesions that may occur, especially in the beard area. The first few lumps do not pain or itch at first, so you might not even notice them. However, they can grow over time and be upsetting, particularly if they show up in private or exposed places.

What Is the Course of Action for Molluscum Contagiosum?

The disease is chronic, whereas autoinoculation and shaving spread it. The inflammation, trauma, and secondary infection promote its spontaneous cure. In atopic individuals, eczema(non-contagious rashes) may develop around the healed lesions.

What Increases the Risk of Developing Molluscum Contagiosum?

• Children between the ages of one to ten years.

• Immunocompromised individuals after organ transplants or cancer treatment.

• People with atopic dermatitis.

• People living in tropical areas.

• People who play sports where there is physical contact.

Diagnosis: Molluscum Contagiosum

• In immunocompetent patients, the diagnosis is quickly made clinically. Extrusion of the cheesy white molluscum body or pearl from the lesion is corroborative.

• In cases of HIV-infected or AIDS patients, disseminated histoplasmosis(fungal infection) or cryptococcosis(fungal infection in which the brain and lungs are affected) may mimic this infection, necessitating histological examination for confirmation.

Treatment: Molluscum Contagiosum

Despite the eventual spontaneous resolution, particularly in children, treatment does help to minimize autoinoculation and prevent transmission to others. Young adults should be evaluated for concomitant sexually transmitted diseases, and their partners have to get treated to avoid reinfection.

• Antibiotics are required if there is a secondary infection.

• Cryotherapy is the molluscum contagiosum treatment of choice.

• The total physical excision of the molluscum body is done by squeezing the papule with blunt forceps or superficial curettage, or shaving with a sharpened wooden spatula.

• Chemicals like phenol, carbolic acid, trichloroacetic acid (TCA), silver nitrate, or iodine solution should be applied carefully after piercing the bumps with a sharpened stick and taking out the molluscum body, avoiding spillage and necrosis of the surrounding skin.

• KOH (potassium hydroxide) applied over lesions for 30 days leads to clearance by digesting proteins.

• Topical five percent Imiquimod cream helps treat giant molluscum.

Recurrent or recalcitrant lesions in the HIV or immunocompromised patient have been treated with the following:

• Topical Tretinoin or five percent Fluorouracil has been used in the treatment of recurrences in the immunocompromised host.

• IV (intravenous) Cidofovir resolved recalcitrant lesions in HIV-infected patients. A topical gel is also being tried.

• Antiretroviral therapy in HIV-infected patients, molluscum contagiosum supportive therapy also causes regression of the lesions.

• Electron beam therapy and pulsed dye laser are molluscum contagiosum medical procedures, have been found helpful in recalcitrant molluscum contagiosum in immunocompromised hosts.

Recognize that you are not alone and that there are options for treatment if you are feeling overwhelmed or ashamed. Knowing that the bumps would eventually go away with time and attention brings relief to many parents and individuals.

What Are Molluscum Contagiosum Complications?

• Impetigo is a secondary bacterial infection caused by scratching.

• Infection of the eyelid causing conjunctivitis(eye inflammation).

• Widespread secondary eczema.

• People with weakened immune systems may develop a large, numerous, and larger-than-normal molluscum contagiosum, which often affects the face.

• Scarring may develop naturally or as a result of surgery.

Prevention: Molluscum Contagiosum

• The only way molluscum contagiosum std can be prevented is by avoiding touching the skin of an infected person or the things touched by an infected person. The following preventive measures should be taken:

• Practice proper handwashing with the help of soap and warm water. Especially, teach kids about the proper handwashing techniques, as they are more susceptible to catching these infections from other children.

• Do not touch or prick areas where lesions are present to avoid the spread of the infection to other parts of the body.

• Avoid sharing personal items like hair brushes, soaps, towels, and clothing as they can harbor the infectious virus.

• Avoid sexual contact with infected persons.

• When infected, try to clean the bumps and cover them to avoid spreading the infection to other people.

• Avoid sharing sports gear that comes in contact with the bare skin of an individual.

• Avoid shaving the areas where the lesion is present..

What Does Molluscum Contagiosum Appear in the Genitals?

Healing molluscum contagiosum in the genital area can affect external areas such as the inner thighs, vulva, anus, penis, and vagina. It can also appear on the groin, abdomen, and buttocks. Molluscum contagiosum in the vaginal area has the following traits:

• Molluscum contagiosum genital in the female genital area or in the male genital area (molluscum contagiosum penis) appears small and firm. These lumps usually have a diameter of one to five mm (millimeters) and can be flesh-colored, pink, or white.

• People with HIV (human immunodeficiency virus) may see these bumps transform into sizable sores over several weeks.

• The bumps can be smooth and painless, though they might be accompanied by itching.

• The bumps tend to group in clusters.

• These bumps could have a central hollow and be surrounded by inflamed skin.

• When scratched, these bumps might get infected, and the healing process could involve scar tissue development.

Conclusion

Molluscum contagiosum is a communicable disease; however, by taking the right precautions, the infection can be stopped from spreading. Educate the child about the mode of virus spread and steps that can be taken to avoid it. Practice good hygiene measures and keep oneself away from the infection.

Key Takeaway from iCliniq

Tiny, raised, flesh-colored pimples are the result of a common viral skin infection called molluscum contagiosum, which is often transferred via contact with contaminated surfaces or other people. Despite being largely benign, this illness, which affects both adults and children, can go untreated for six months to four years. Although 90 percent of cases resolve naturally, medical intervention, such as topical treatments or cryotherapy, may be necessary for chronic or widespread outbreaks.

Here at iCliniq, our dermatologists' consultation, for an accurate diagnosis and treatment advice, is best if you are having recurrent or widespread bumps, especially in sensitive places.