Published on Jul 27, 2016 and last reviewed on Sep 02, 2022 - 4 min read
Abstract
Molluscum contagiosum is a contagious viral infection, which results in raised nodules on the skin. Learn about its clinical presentation, diagnosis, and treatment.
Most patients describe molluscum contagiosum in adults, a sexually transmitted disease (STD), as asymptomatic pimples over the genitalia. It is basically caused by the Molluscum contagiosum virus, a DNA virus of the poxvirus family. It spreads by close contact commonly with the children, the immunocompromised, and increasingly younger adults, in the latter as a sexually transmitted disease. The incidence peaks at 5-10 years of age.
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-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 sharing personal items, toys, etc.
Molluscum contagiosum 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.
After a variable incubation period (14 days to 6 months), typical lesions start as small whitish papules and gradually enlarge to become characteristic shiny, pearly white, hemispherical, dome-shaped, 5-10 mm 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.
In HIV infection or AIDS 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.
Giant lesions or grape-like clusters of multiple small lesions may occur, especially in the beard area.
The disease is chronic, whereas autoinoculation and shaving spread it. The inflammation, trauma, and secondary infection, promote its spontaneous cure. In atopic individuals, eczema may develop around the healed lesions.
Children between the age 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.
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 or cryptococcosis may mimic this infection, necessitating histological examination for confirmation.
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 in order to avoid reinfection.
Antibiotics are required if there is a secondary infection.
Cryotherapy is the 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 5% Imiquimod cream is helpful in treating giant molluscum.
Recurrent or recalcitrant lesions in the HIV or immunocompromised have been treated with the following:
Topical Tretinoin or 5% Fluorouracil has been used in the treatment of recurrences in the immunocompromised host.
IV Cidofovir resolved recalcitrant lesions in the HIV infected. A topical gel is also being tried.
Antiretroviral therapy in HIV infected patients also causes regression of the lesions.
Electron beam therapy and pulsed dye laser have been found helpful in recalcitrant molluscum contagiosum in immunocompromised hosts.
The only way molluscum contagiosum can be prevented is by avoiding touching the skin of an infected person or the things touched by an infected person. Following preventive measures should be taken:
Practice proper handwashing with the help of soap and warm water. Especially, teach your 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 or when you have genital bumps.
When infected, try to clean your 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.
Conclusion:
Although molluscum contagiosum is a contagious disease, the spread of the infection
can be prevented by following adequate measures. Do educate your child about the mode of virus spread and steps that can be taken to avoid it. Practice good hygiene measures and keep yourself away from the infection.
The most important cause of molluscum contagiosum are viral infections.
They are known to spread by the following conditions:
- Contact with contaminated objects, such as towels.
- Skin-to-skin contact.
- Rubbing or scratching the bumps, which spreads the virus to the skin in the nearby region.
- Sexual contact with an affected partner.
Yes, molluscum contagiosum is a sexually transmitted infection. There are higher possibilities for the virus to spread from the infected person to a healthy person through sexual contact. The condition usually resolves by itself. Following proper hygiene serves as a prevention measure.
The recovery of molluscum contagiosum depends on the immune power of an individual. In the majority of the cases, special treatment methods are not required because it is a self-healing condition. If the condition causes pain and scarring, then the doctor will recommend medications and laser therapy. Topical applications of Podophyllotoxin cream are known to be beneficial.
The home remedies for molluscum contagiosum include the following:
- Bath with colloidal oatmeal. The colloidal form of oatmeal is made into a fine powder and added to the lukewarm water. Oatmeal has anti-inflammatory properties and can help in relieving the itching sensation caused by molluscum contagiosum.
- Application of tea tree oil. Tea tree oil has antiseptic properties.
- Coconut oil. Coconut oil is efficient in providing a soothing effect on the skin. It also reduces the itching sensation.
- Australian lemon myrtle. The application of Australian lemon myrtle is known to reduce the symptoms of molluscum contagiosum. It requires a regular application of 21 days.
It usually takes about two or three months for the bumps caused by molluscum contagiosum to go. The efficient ways to remove the bumps quickly are:
- Cut or scrape off the bumps.
- Topical application of medications on the bumps.
- Oral medications to treat molluscum contagiosum.
Most of the doctors do not recommend faster treatment procedures because it might cause severe burns that are painful and itchy in nature.
Yes, kids with molluscum contagiosum can go to school and other public places. It is also necessary for the child to wash their hands regularly with soap and water. The child should have the bumps properly covered with bandages. You might take help from your doctor for dressing the wound.
Yes, you can get molluscum contagiosum from your child. Once the child is known to be infected from molluscum contagiosum, there are possibilities for the child to spread the infection to other areas in their own body or to others. Direct contact with the molluscum contagiosum lesions can increase the chances of spreading.
Molluscum contagiosum can be treated with Imiquimod cream. Imiquimod cream is beneficial for the treatment of larger lesions. People who have poor immune systems are known to get high benefits from Imiquimod cream. It acts by stimulating the immune system of the body.
Yes, apple cider vinegar works for molluscum contagiosum. There is no proper evidence to prove it, but the application of apple cider vinegar is known to suppress the itching and tingling sensation in the skin.
If you are experiencing rashes that are itchy, then you can use topical steroids such as Hydrocortisone. It is available over-the-counter. It is helpful for subsiding the inflammation also.
Your child might have got molluscum contagiosum while playing with other kids. They might have touched the bumps of molluscum contagiosum knowingly or unknowingly. Sharing the cloths, towels, bed, and toys are the common causes of spreading molluscum contagiosum.
A person infected with molluscum contagiosum stays contagious till the disappearance of the last bump of the lesion. The bumps might last for nearly six to 12 months. In some patients, the lesions can last up to four years. The patient will not be contagious if all the lesions have been resolved.
The majority of the people are known to have the immense capacity to act against molluscum contagiosum. As a result, they do not show any development of lesions. Only a few degrees of the population are not known to have ideal immune functions to act against infection. In such patients, the lesions appear after two to seven weeks.
Molluscum contagiosum is very common in the United States of America. It is also known to have an international occurrence rate. HIV patients are affected by more than healthy adults. Tropical areas of the world are affected more. It is more common in males than in females. It has a rare occurrence in babies less than one year of age.
The lesions of molluscum contagiosum are known as Mollusca. It appears as a pinkish-white lesion that is very small but raised. It has a pit or dimple in the center of the lesion. It has a pearly appearance. Mollusca is usually firm and smooth. It is seen on the neck, face, legs, arms, genital area, and abdomen.
The lesions of molluscum contagiosum are known as Mollusca. It appears as a pinkish-white lesion that is very small but raised. It has a pit or dimple in the center of the lesion. It has a pearly appearance. Mollusca is usually firm and smooth. It is seen on the neck, face, legs, arms, genital area, and abdomen.
Molluscum contagiosum is caused by a poxvirus. It is called the molluscum contagiosum virus. It happens to come from direct skin to skin contact or sexual intercourse. It is usually a benign infection and can appear in any part of the body.
In adults, molluscum contagiosum is known to have a higher spreading rate because adults might get this infection by sexual route. Direct contact with the infected part of the skin also serves as a contributing factor for the spread.
Last reviewed at:
02 Sep 2022 - 4 min read
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Dermatology
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