Molluscum
SUMMARY: Molluscum contagiosum virus infections and current treatment guidelines.
Fact Sheet
Introduction
Common chronic, localized infection, consisting of skin-coloured, dome-shaped bumps on the skin, usually in children.
Virology
Poxvirus
Epidemiology
Four distinct gentoypes
MCV1 most common > 90% of cases
25% of people have positive serology
Risk Factors
Common in childhood
In adults can be linked to sex and contact sports
Associated with immunodeficient states
Transmission
Skin to skin contact
Indirect contact via shared towels or items
Auto-innoculation from shaving or scratching
Sexual transmission in adults
Molluscum prefers wet conditions such as swimming or bathing together
Incubation periods about 2 weeks but can be 6 months
Clinical
Clusters of small, round papules
1 to 6 mm in diameter, but can grow to 2cm
May be white, ink or brown
Waxy shiny look with small central pit
Papules contain white cheesy material
Mostly arise in warm moist places, armpit, behind knee, and groin
Complications
Secondary bacterial infection from scratching
Conjunctivitis if eyelid infected
Disseminated eczema
Scarring
Diagnosis
Clinical
Treatment
As molluscum is self-limiting, treatment is not always necessary.
Physical
Taping
Picking out the soft white core
Cryotherapy
Curettage
Laser ablation
Medical
Antiseptics such as hydrogen peroxide cream or iodine
Podophyllotoxin cream
Wart parts containing salicylic acid
Cantharidine solution
Outcome
In people with a competent immune system, molluscum is harmless. They may persist for up to 2 years. 50% of cases in kids clear by 12 months and 67% by 18 months.
Prevention
Keep hands clean
Avoid scratching or shaving
Cover all visible lesions with clothing or water-tight bandages
Dispose of used bandages
Do not share towels, clothing or their personal effects
Adults should practice safe sex or abstain
Treat any associated eczema
Reference
Molluscum Dermnet
Molluscum Guidelines Royal Children’s Hospital
Molluscum Fact Sheet Royal Children’s Hospital
Molluscum Up To Date
Molluscum Raising Children Network
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