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Molluscum contagiosum

 

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 different ways.

This is a common infection in children and occurs when a child comes into direct contact with a lesion or an object that has the virus on it. The infection is most often seen on the face, neck, armpit, arms, and hands. But it 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 genitals 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 HIV/ AIDS ) may have a rapidly spreading case of molluscum contagiosum.

Symptoms

 

The infection on the skin begins as a small, painless papule. It may become raised to a pearly, flesh-colored nodule. The papule often has a dimple in the center. Scratching or other irritation causes the virus to spread in a line or in groups, called crops.

The papules are about 2 to 5 millimeters wide. Usually, there is no inflammation (swelling and redness) and no redness unless you have been digging or scratching at the lesions (abnormal areas on the skin).

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 will examine the lesion to rule out other disorders and to determine other underlying disorders.

 

Treatment

 

In people with a healthy immune system, the disorder usually goes away on its own over months to years. But the lesions can spread before they go away.

Individual lesions may be removed surgically. This is done by scraping, de-coring, freezing, or through needle electrosurgery. Laser treatment may also be used. Surgical removal of individual lesions may result in scarring.

Medicines, such as salicylic acid preparations used to remove warts , may be helpful. But these medicines can cause blistering that leads to temporary skin discoloration. Cantharidin, commonly called beetle juice, is the most common solution used to treat the lesions in the provider's office. Tretinoin cream or imiquimod cream may also be prescribed.

 

Outlook (Prognosis)

 

Molluscum contagiosum lesions may persist from a few months to a few years. They eventually disappear without scarring, unless there has been excessive scratching, which may leave marks.

The lesions usually all disappear within 6 to 18 months. The disorder may persist in immunosuppressed people.

 

Possible Complications

 

Problems that can occur include any of the following:

  • Persistence, spread, or recurrence of lesions
  • Secondary bacterial skin infections

 

When to Contact a Medical Professional

 

Call for an appointment with your provider if:

  • You have a skin problem that looks like molluscum contagiosum
  • Molluscum contagiosum lesions persist or spread, or if new symptoms appear 

 

Prevention

 

Avoid direct contact with the skin lesions. Do not share towels or other personal items, such as razors and make-up, with other people.

Avoiding sex can also prevent getting the 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 can't fully protect you, as the virus can be on areas not covered by the condom. Even so, condoms should still be used every time the disease status of a sexual partner is unknown. Condoms reduce your chances of getting or spreading STDs.

 

 

References

Damon IK. Other poxviruses that infect humans. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 136.

Javed A, Coulson I. Molluscum contagiosum. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 149.

 
  • Molluscum contagiosum - close-up - illustration

    Molluscum is a viral infection which generally goes away by itself (is self-limited). The lesions are typically raised, firm, flesh-colored bumps (papules) with a pearly or smooth shiny appearance.

    Molluscum contagiosum - close-up

    illustration

  • Molluscum contagiosum - close-up of the chest - illustration

    Molluscum is a benign infection which is generally self-limited. The lesions are typically raised, firm, flesh-colored bumps (papules) with a pearly or smooth shiny appearance. These are classical appearing Molluscum. The large lesion in the center is one that has been picked and scratched and shows evidence of low-grade inflammation.

    Molluscum contagiosum - close-up of the chest

    illustration

  • Molluscum on the chest - illustration

    These lesions are associated with the molluscum virus and are present on a person who has a weakened immune system (immunocompromised). Molluscum contagiosum are small, raised, pearly skin lesions caused by the molluscum virus, a member of the poxvirus family. They are seen frequently in children and less often in adults. In adults, they may be considered a sexually transmitted disease. Immunocompromised individuals may experience heavy outbreaks of these lesions, as seen in this photograph.

    Molluscum on the chest

    illustration

  • Molluscum, microscopic appearance - illustration

    This is how a molluscum lesion appears under microscopic examination. Molluscum are small, raised, pearly skin lesions caused by the molluscum virus, a member of the poxvirus family.

    Molluscum, microscopic appearance

    illustration

  • Molluscum contagiosum on the face - illustration

    Molluscum contagiosum is most commonly seen in children, however it does occur in adults and may cause extensive infection in people with weakened immune systems. In this photograph, multiple small molluscum are seen covering the cheek, upper neck, and in the sideburn.

    Molluscum contagiosum on the face

    illustration

    • Molluscum contagiosum - close-up - illustration

      Molluscum is a viral infection which generally goes away by itself (is self-limited). The lesions are typically raised, firm, flesh-colored bumps (papules) with a pearly or smooth shiny appearance.

      Molluscum contagiosum - close-up

      illustration

    • Molluscum contagiosum - close-up of the chest - illustration

      Molluscum is a benign infection which is generally self-limited. The lesions are typically raised, firm, flesh-colored bumps (papules) with a pearly or smooth shiny appearance. These are classical appearing Molluscum. The large lesion in the center is one that has been picked and scratched and shows evidence of low-grade inflammation.

      Molluscum contagiosum - close-up of the chest

      illustration

    • Molluscum on the chest - illustration

      These lesions are associated with the molluscum virus and are present on a person who has a weakened immune system (immunocompromised). Molluscum contagiosum are small, raised, pearly skin lesions caused by the molluscum virus, a member of the poxvirus family. They are seen frequently in children and less often in adults. In adults, they may be considered a sexually transmitted disease. Immunocompromised individuals may experience heavy outbreaks of these lesions, as seen in this photograph.

      Molluscum on the chest

      illustration

    • Molluscum, microscopic appearance - illustration

      This is how a molluscum lesion appears under microscopic examination. Molluscum are small, raised, pearly skin lesions caused by the molluscum virus, a member of the poxvirus family.

      Molluscum, microscopic appearance

      illustration

    • Molluscum contagiosum on the face - illustration

      Molluscum contagiosum is most commonly seen in children, however it does occur in adults and may cause extensive infection in people with weakened immune systems. In this photograph, multiple small molluscum are seen covering the cheek, upper neck, and in the sideburn.

      Molluscum contagiosum on the face

      illustration

    Self Care

     

     

    Review Date: 4/14/2015

    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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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