| Definition: |
A viral skin infection that causes raised pearl-like papules or nodules on the skin.
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| Causes, incidence, and risk factors: |
Molluscum contagiosum is caused by a virus that is a member of the Poxvirus family. This virus is called Molluscipoxvirus Molluscum contagiosum.
This is a common infection in children. It is frequently seen on the face, neck, axilla (arm pit), arms, and hands but may occur anywhere on the body except the palms and soles. On occasion it is seen on the genitalia.
In adults, molluscum is generally seen on the genitalia as a sexually-transmitted disease. Because molluscum produces no systemic illness and is not of long-term public health or economic significance, it has not been treated as other sexually-transmitted diseases. The importance is significant in the growing population of immunocompromised people with AIDS, who may develop a fulminating (rapidly worsening) case of molluscum contagiosum.
Typically the lesion of molluscum begins as a small papule which may become raised up to a pearly, flesh-colored nodule. The papule often has a dimple in the center (umbilication). These papules may occur in lines, where the person has scratched. Scratching or other local mechanical irritation causes the virus to spread in a line or in groups (crops). The papules are approximately 2 to 5 millimeters in diameter and painless. There is usually no inflammation and subsequently no redness unless the person has been digging or scratching at the lesions. In the mature molluscum, the top of the nodule may be opened with a sterile needle and a small waxy core can be seen and squeezed out of the lesion.
Molluscum contagiosum is a chronic infection and lesions may persist from a few months to a few years. These lesions ultimately disappear without scarring. Early lesions on the genitalia may be mistaken for herpes or warts but, unlike herpes, these lesions are painless.
The virus is contagious through direct contact, as seen in children, but may spread by sexual contact. It can spread locally (autoinoculation) by shedding of the virus from lesions to adjacent normal skin areas.
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| Symptoms: |
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skin lesion
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papule or nodule
- small, 2 to 5 millimeter diameter
- dimple in center of lesion (umbilicated)
- initially firm, flesh colored, pearl like, dome shaped
- later lesions become softer, gray, and may drain
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central core or plug of white, cheesy or waxy material
- painless
- single or multiple (usually multiple)
- common locations in children: face, trunk, limbs
- common locations in adults: genitals, abdomen, inner thigh
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| Signs and tests: |
Diagnosis is based on the appearance of the lesion and can be confirmed by a skin biopsy. The health care provider should examine the lesion to rule out other disorders and to determine other underlying disorders.
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| Treatment: |
In people with normal immune systems, the disorder usually disappears spontaneously over a period of months to years. The lesions may be extensive in people with AIDS or other conditions that affect the immune system. Individual lesions may be removed surgically, by scraping, de-coring, freezing, or through needle electrosurgery. Surgical removal of individual lesions may result in scarring. Medications, such as those used to remove warts, may be helpful in removal of lesions.
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| Expectations (prognosis): |
Individual lesions of molluscum contagiosum usually disappear within about 2 to 3 months. Complete disappearance of all lesions generally occurs within about 6 to 18 months. The disorder may persist in immunosuppressed people.
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| Complications: |
- persistence, spread, or recurrence of lesions
- secondary bacterial skin infections
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| 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.
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| Prevention: |
Avoid direct contact with skin lesions. Safer sex behaviors (such as limiting partners) may help in the prevention of this viral infection.
Condoms will prevent the spread of molluscum virus when used CONSISTENTLY and PROPERLY. Condoms remain the best protection when the disease status of a sexual partner is unknown, and will prevent the spread of not only molluscum contagiosum but other sexually-transmitted diseases.
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