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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, incidence, and risk factors

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. It is frequently seen on the face, neck, armpit, arms, and hands but 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 AIDS ) may have a rapidly spreading case of molluscum contagiosum.

Symptoms

The lesion of molluscum 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 subsequently no redness unless you have been digging or scratching at the lesions.

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.

Signs 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 healthy immune systems, 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 those 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. Tretinoin cream or imiquimod cream may also be prescribed.

Expectations (prognosis)

Molluscum contagiosum lesions may persist from a few months to a few years. These lesions ultimately disappear without scarring, unless there is excessive scratching, which may leave marks.

Complete disappearance of all lesions generally occurs within 6 to 18 months. The disorder may persist in immunosuppressed people.

Complications

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

Calling your health care provider

Call for an appointment with your health care provider if you have symptoms suggestive of molluscum contagiosum. Also call for an appointment with your health care provider if 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 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 cannot 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: parapoxviruses, molluscum contagiosum, and yatapoxviruses. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Elsevier Churchill-Livingstone; 2009:chap 134.

Mancini AJ, Shani-Adir A. Other viral diseases. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, Pa.: Elsevier Saunders; 2012:chap 81.

Updated: 5/15/2013

Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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