About molluscum contagiosum
Molluscum contagiosum is the result of infection of epidermal cells (upper cells of skin) by a poxvirus. It appears as small umbilicated, dome-shaped, skin-colored lesions. A “cheesy” substance can often be expressed from the lesion. Although it can be transmitted sexually, it is also a common non-sexually transmitted infection of childhood. In children, lesions are grouped on the face (often about the eye), trunk, and extremities, while in adults it may also be found in the genital region as a result of sexual transmission.
With what can molluscum contagiosum be confused?
Molluscum contagiosum can be confused with the pearly appearance of a basal cell carcinoma, but the former lack telangietasia. It can also resemble acne vulgarus.
How is molluscum contagiosum diagnosed?
Molluscum contagiosum is usually diagnosed clinically. If doubt exists, microscopic examination of the expressed cheesy core will reveal molluscum bodies (intracytoplasmic aggregations of virus particles). Widely disseminated lesions that do not regress are characteristic of AIDS, and should prompt investigations for HIV.
How is molluscum contagiosum treated?
Molluscum contagiosum lesions are best treated by physical destruction. Cryotherapy and curettage are common modalities. If these treatments cannot be tolerated in young children, topical salicylic acid, trichloroacetic acid, tretinoin, or cantharidin can be effective. Imiquimod (e.g. Aldara), an immune modulator, has been used as well with varied results. The systemic agents cimetidine and griseofulvin have been reported in small series to be beneficial. However, for treating multiple lesions quickly, the V-beam pulsed dye laser is the treatment of choice for molluscum contagiosum.
What is the prognosis for molluscum contagiosum?
The lesions of molluscum contagiosum usually remit spontaneously over several months, though additional lesions may also appear. Molluscum contagiosum is contagious, and can also be spread within the affected individual by autoinoculation. Lesions can sometimes get secondarily infected or inflamed.
