DERMATOLOGY,  VIRAL

Molluscum contagiosum

Overview

  • Definition: Common viral skin infection in childhood causing localized clusters of epidermal papules (mollusca)
  • Cause: Poxvirus, molluscum contagiosum virus
  • Appearance: Small, round, waxy, shiny papules containing white cheesy material
  • Nature: Relatively harmless; papules may persist for up to 2 years or longer
  • Resolution in Children:
    • About ½ clear by 12 months
    • ⅔ clear by 18 months, with or without treatment

Age and Prevalence

  • Mostly Affects: Infants to 10 years old
  • Less Common: Adolescents and adults
  • More Prevalent: In warm climates

Spread

  • Direct Contact: Skin-to-skin
  • Indirect Contact: Shared towels or other items
  • Auto-Inoculation: Scratching or shaving
  • Sexual Transmission: In adults
  • Common Activities: When children bathe or swim together
  • Incubation Period: 2 weeks to 6 months

Complications

  • Secondary Bacterial Infection: From scratching (impetigo)
  • Conjunctivitis: When the eyelid is infected
  • Disseminated Secondary Eczema
  • Scarring: Due to surgical treatment

Treatment

Physical Treatments

  • Picking Out Core: Risk of autoinoculation
  • Cryotherapy: May leave white marks
  • Gentle Curettage or Electrodessication: Can cause scarring
  • Laser Ablation: Can cause scarring

Medical Treatments

  • Antiseptics: Hydrogen peroxide cream or povidone iodine solution
  • Podophyllotoxin Cream
  • Wart Paints: Containing salicylic acid
  • Cantharidine Solution
  • Imiquimod Cream and Sinecatechins: Sometimes used but unproven
  • Secondary Dermatitis: Treated symptomatically with mild topical corticosteroids such as hydrocortisone cream

Prevention

  • Infectious Period: Molluscum contagiosum is infectious while active
  • Attendance: Affected children and adults should continue attending daycare, school, and work
  • Hygiene Measures:
    • Keep hands clean
    • Avoid scratching or shaving
    • Cover all visible lesions with clothing or watertight bandages
    • Dispose of used bandages
    • Do not share towels, clothing, or other personal effects
    • Adults should practice safe sex or abstinence to prevent sexual transmission

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