Molluscum contagiosum is a self-limited epidermal viral infection, characterized clinically by skincolored papules that are often umbilicated, occurring in children and sexually active adults. In HIVinfected individuals, however, numerous large mollusca often arise on the face, causing significant cosmetic disfigurement.
Causes of Molluscum Contagiosum
Molluscum contagiosum can be spread from person to person (especially children) by direct skin contact. This appears to be more likely in wet conditions, such as when children bathe or swim together. Sexual transmission is possible in adults.
Lesions tend to be more numerous and last longer in children who also have atopic eczema. It can be very extensive and troublesome in patients with human immunodeficiency virus infection.
Heat and moisture in the fold areas of skin, such as the armpits, may hasten the spread of the virus.
Symptoms of Molluscum Contagiosum
- Pink, pearl-like spots on the face, arms and legs, which can be 1 to 5mm in diameter.
- Later lesions become softer, gray, and may drain.
- In most patients, the lesions are asymptomatic. They may be complicated by secondary bacterial infections. They may cause itching and consequent eczema around the tumors.
- Eczema develops around the lesions.
- Scarring may occur, particularly if the lesions become infected.
Diagnosis
Usually made on clinical findings. Biopsy lesion in HIV-infected individual if disseminated invasive fungal infection is in the differential diagnosis.
Treatment
Supportive Therapy
In immunocompetent children and sexually active adults, mollusca regress spontaneously; painful aggressive therapy is not indicated.
Treatment of lesions
- Topical patient-directed therapy Aldara cream (5% imiquimod) applied hs 3 times per week for up to 1-3 months.
- Cryosurgery Freezing lesions for 10-15 s is effective and minimally painful, using either a cotton-tipped applicator or liquid nitrogen spray.
Prevention
Avoid skin-to-skin contact with individual having mollusca. HIV-infected individuals with mollusca in the beard area should be advised to minimize shaving facial hair or grow a beard.
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