Molluscum Contagiosum

Introduction

Molluscum Contagiosum is a common infection caused by a large epidermotropic pox virus.
It is common in children and is Spread by direct human to human contact.
In adults it is often transmitted during sexual intercourse.

Symptoms and Clinical features of Molluscum Contagiosum

  • Individual lesions are smooth-surfaced, firm, dome-shaped, pearly papules; average diameter 3-5 mm
  • Some “giant” lesions may be up to 1.5 cm in diameter
  • Characteristic central umbilication
  • Spontaneous resolution is expected
  • Host response plays an important role
  • Children with widespread molluscum contagiosum usually have atopic dermatitis
  • Consider HIV in adults.

Differential diagnoses

  • Viral warts
  • Giant molluscum contagiosum may mimic basal cell epithelioma

Complications of molluscum contagiosum

  • Secondary bacterial infection

Investigations

  • Histopathology of the expressed pasty core

Treatment for molluscum contagiosum

Treatment objectives

  • Eradicate the skin lesions

Non-drug treatment

  • Light electrosurgery with a fine needle
  • Cryotherapy with trichloroacetic acid 35% – 100%
  • Curettage and paint with iodine

Drug treatment

Cimetidine

  • Adult: 40 mg/kg/day orally for 2 months
  • Child:
    • not licensed for use in children less than 1 year.
    • 1 month – 12 years: 5 – 10 mg/kg (maximum 400 mg) 4 times daily
    • 12-18 years: 400 mg orally 4 times daily

Antibiotics

  • To prevent or treat secondary infection

Prevention of molluscum contagiosum

  • Avoid direct skin contact with an infected person