Molluscum Contagiosum

Abstract

Molluscum contagiosum is a contagious viral infection, which results in raised nodules on the skin. Learn about its clinical presentation, diagnosis, and treatment.

Molluscum contagiosum in adults, a sexually transmitted disease (STD), is described as asymptomatic pimples over the genitalia by most of the patients. It is basically caused by 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.

Presentation in Sufferer

After a variable incubation period (14 days to 6 months), typical lesions start as small whitish papules and gradually enlarge to become typical shiny, pearly white, hemispherical, dome-shaped, 5-10 mm umbilicated papules with central depression.

Lesions are mostly 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.

Atypical presentation can occur over scalp, lips, palms and soles and 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 grapelike clusters of multiple small lesions may occur, especially in the beard area.

Course of Action

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.

Diagnosis

In immunocompetent patients, the diagnosis is easily done 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.

Treatment

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

Antibiotics are required if there is secondary infection.

Cryotherapy is the treatment of choice.

Physical expression of the molluscum body in total by squeezing a 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 very carefully, after piercing the papules 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 Tretinion or 5% Fluorouracil has been used in the treatment of recurrences in the immune compromised host.
IV Cidofovir resolved recalcitrant lesions in the HIV infected. A topical gel is also being tried.
Antiretroviral therapy in HIV infected also causes regression of the lesions.
Electron beam therapy and pulsed dye laser have been found useful in recalcitrant molluscum contagiosum in immunocompromised hosts.

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Frequently Asked Questions

1. What Are the Causes of Molluscum Contagiosum?

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.

2. Is Molluscum Contagiosum a STD?

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.

3. How Do You Get Rid of Molluscum Contagiosum?

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.

4. How Do You Get Rid of Molluscum Contagiosum at Home?

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.

5. What Is the Fastest Way to Get Rid of Molluscum Contagiosum?

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.

6. Can a Child Go to School With Molluscum Contagiosum?

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.

7. Can I Catch Molluscum From My Child?

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.

8. What Cream Can I Use for Molluscum?

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.

9. Does Apple Cider Vinegar Work for Molluscum?

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.

10. Can You Use Hydrocortisone on Molluscum Contagiosum?

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.

11. How Did My Child Get Molluscum Contagiosum?

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.

12. During What Stage Is Molluscum Contagiosum Contagious?

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.

13. Who Is Immune to Molluscum Contagiosum?

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.

14. How Common Is Molluscum Contagiosum?

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.

15. How Does Molluscum Contagiosum Look Like?

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.

16. How Does Molluscum Contagiosum Look Like?

17. What Virus Causes Molluscum Contagiosum?

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.

18. How Contagious Is Molluscum Contagiosum in Adults?

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.