Overview
Molluscum contagiosum is a common viral infection of the skin that resolves on its own, usually within a few months. It is caused by the poxvirus and affects only humans. It can spread to other areas of the skin by scratching or rubbing and can be transmitted to other people by skin-to-skin contact or handling contaminated objects such as towels, toys, and clothing. Poor hygiene and warm, moist climates encourage the spread of molluscum contagiosum. Use of public swimming pools is a common source of childhood infections.
Signs and Symptoms
One or more small (1–5 mm) pink, white, or skin-colored, smooth, dome-shaped bumps, often with a tiny dot or depression in the center, occur in clusters and sometimes in a straight line from scratching and self-introduction (self-inoculation). In patients with an immune system deficiency, bumps can be larger than a nickel.
- Mild molluscum infection – under 10 spots
- Moderate molluscum infection – 10–50 spots
- Severe molluscum infection – over 50 spots
Molluscum contagiosum lesions are typically small, dome shaped, and can have a small dimple in their center. Although often flesh colored, but can also be pink. They are usually found alone or grouped on a child's trunk, axilla, or skin folds of their elbow and knees.
For many children, molluscum don't cause any symptoms and the rash can simply be a cosmetic problem. Others can get redness and scaling on the skin around the molluscum rash, which may be itchy.
Another characteristic is that molluscum will sometimes have a plug of cheesy material coming out of the central part of the lesion.
Molluscum Diagnosis
The diagnosis of molluscum is usually made by the classic appearance of the molluscum lesions.
The diagnosis can be confusing at first though, when the molluscum are still very small. It may take a few weeks for the lesions to grow before they look like more typical molluscum lesions.
Molluscum Treatments
Since molluscum usually goes away in about six to nine months on its own, some pediatricians advocate not treating it. Keep in mind that it can sometimes last for two to four years and may spread aggressively, which is why others do recommend treating molluscum with:
- Direct removal with a curette
- Cryosurgery - freezing
- Cantharidin - a blistering agent
- Aldara (Imiquimod) - also used for genital warts, although they are not related to molluscum
- Retin A (Tretinoin) - also used for acne
All of these treatments have their shortcomings though. Direct removal and cryosurgery are painful. Cantharidin can cause large blisters. Aldara is expensive. And Retin A doesn't always work well when used by itself.
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