What is molluscum contagiosum?

What is molluscum contagiosum?

Molluscipoxvirus, or molluscum contagiosum is a common and contagious skin infection caused by the molluscum contagiosum virus. It causes raised, pearl-like nodules or papules on the skin.

These papules are called molluscum bodies, mollusca, or condyloma subcutaneum.

Molluscum contagiosum virus (MCV) mostly affects children under the age of 15 years. It most commonly affect children aged between 1 and 10 years.

MCV type 1 is the most common type, and it is most likely to be seen in children. MCV type 2 is sexually transmitted, and it is more common among adults.

The papules are generally painless, and they do not itch. They can affect any area of skin but especially the trunk of the body, arms, and legs. According to the Centers for Disease Control and Prevention (CDC), they mostly heal without intervention within 6 to 12 months, and they do not leave scars. In some cases, however, it may take up to 4 years to resolve.

The exact prevalence is unknown, because many people do not seek medical advice.

Treatment is not generally necessary, because the condition is self-limiting, but it can stop MCV from spreading.

Symptoms of molluscum contagiosum

The MCV virus causes bumps on the skin.

For most people, symptoms only appear on the skin. After initial infection, it can take from 7 days to 6 months for symptoms to emerge. The American Academy of Dermatology notes that it often takes 7 weeks for the bumps to appear.

The papules appear as small, firm, flesh-colored, dome-shaped, pearly, wart-like spots on the skin.

They are typically 1 to 5 millimeters in diameter, with a dimpled center. These "Mollusca" tend to develop on any part of the skin that is not usually covered, such as the arms, face, and hands, but sometimes the chest and stomach too.

Sexually-transmitted Mollusca generally appear on the genitalia, groin, lower abdomen, and inner thighs.

They usually develop in small clusters, and they remain on the top layer of the skin, but they can spread to other parts of the body.

Some Mollusca have a small white dot with pus, and they release a thick, white fluid when burst. The dimpled part may bleed.

Most patients will have up to 20 papules, but some may have over 100. If there are many, or if they are more than 5 millimeters across, medical advice should be sought, because this may mean there is a problem with the immune system.

After about 6 to 12 weeks the Mollusca will crust over and then heal. A tiny patch of lighter skin or a pitted mark may remain, but there will not usually be any scars.

For a year or more, new Mollusca may continue to form in other parts of the body as old ones crust over and heal. Once they disappear completely, they are highly unlikely to come back.

In rare cases, the Mollusca may persist for years.

How does molluscum contagiosum spread?

The virus is contagious until the bumps are gone.

MCV can spread through close, direct contact with an infected person, normally through skin-to-skin contact, as in sexual contact or by touching or scratching the bumps and then touching the skin.

It can also spread to different parts of the body, and to other people if they touch contaminated objects, such as towels.

Most people are resistant to the virus, and they are unlikely to become infected unless their immune system is compromised.

Among children, MCV can be common, but because it is benign and self-limiting, there is no need to miss days of school.

Treatment options for molluscum contagiosum

Medical advice is not always necessary, as the condition is self-limiting. However, if people do seek help, the physician may offer a number of treatment options.

Laser treatment is one option.

Curettage involves scraping the papule away using a curet, a spoon-shaped instrument with a sharp edge, possibly under local anesthetic.

Cryotherapy uses pressurized liquid spray to freeze the papule. Each lesion is frozen for up to 10 seconds, or until a layer of ice forms over the spot and surrounding skin. Sometimes several sessions are needed.

Diathermy uses a heated electrical device to burn off the Mollusca, under a local anesthetic.

Laser therapy uses intense, narrow beams of light.

Chemical treatment is possible, where the doctor dips a sharp metal instrument into either podophyllin or phenol and then pricks each Mollusca. These eventually burst and empty out their contents. This can cause scarring and is said to be uncomfortable.

If a patient develops dermatitis or eczema around the papules, the doctor may recommend a hydrocortisone cream, an ointment to relieve any itching, or a prescription topical steroid. These are applied to the areas of dermatitis and not to the papules.

A patient with a weakened immune system will need specialist treatment, depending on the extent of the MCV and the reason for the weakened system.

MCV does not stay dormant in the body, and it does not reappear. When it is gone, it is unlikely to return, unless there is a new infection.

Complications of molluscum contagiosum

Although the papules are not usually painful or itchy, other conditions can develop.

Eczema can appear around the Mollusca in some cases, causing itching, swelling, and sometimes pain. Eczema can lead to scratching, and this can increase the risk of infection and spreading of the virus, as well as slowing down the healing process.

Picking or scratching the bumps can also lead to bacterial infection and itching. The doctor may prescribe antibiotics.

Complications are more likely to affect people with a weakened immune system. This can be because of HIV, chemotherapy or the use of certain medications.

Scarring may remain as small patches of paler skin or tiny indents. If infection occurs, scarring is more likely.

Eye complications, such as conjunctivitis or keratitis, can occur if MCV is around the eyes. The patient will be referred to an eye specialist.

Preventing molluscum contagiosum

A number of precautions can help to stem the spread of MCV.

  • Practice good hand hygiene, especially if there is someone with MCV in the household.
  • Cover the Mollusca if there is a risk of other people having skin-to-skin contact.
  • Avoid contact sports, such as judo, wrestling, or rugby.
  • Do not touch, scratch or rub the papules. After touching them, the patient should wash their hands at once with warm water and soap.
  • Do not shave over affected areas of skin, because this can encourage the infection to spread.
  • Do not share personal items, such as clothing, towels, flannels, and hairbrushes with a person who has MCV.

An adult with MCV should avoid physical contact until the Mollusca have completely gone. Condoms do not provide total protection from MCV spread, as the virus can pass between areas of skin that are not covered by a condom.

In swimming pools, MCV is most likely transmitted through items that are touched outside the pool, such as towels and diving boards rather than in the chlorinated water. Papules should be covered with watertight bandages before swimming.

Molluscum Contagiosum Medical Course (Video Medical And Professional 2020).

Section Issues On Medicine: Medical practice