Molluscum Contagiosum

Molluscum Contagiosum

Molluscum contagiosum is an infection caused by a poxvirus (molluscum contagiosum virus). This viral skin infection is characterized by single or multiple raised, pearl-like bumps (papules) on the skin that may appear anywhere on the body.

How does molluscum contagiosum spread?

Molluscum contagiosum is spread through skin contact with the virus. This can occur if you come into direct contact with someone else’s molluscum lesions, be it through sexual contact, or during contact sports.

This virus can also spread through contact with contaminated fomites. Fomites are inanimate objects that can become contaminated with the virus. Meaning that the virus can survive on surfaces outside the body and can remain on infected surfaces like clothing, towels, gym equipment etc. Someone else who then comes into contact with these surfaces can get infected. 

The molluscum contagiosum virus remains in the top layer of skin (epidermis) and does not circulate throughout the body. Once the lesions are healed, the area no longer contains the virus. Molluscum contagiosum is not like herpes viruses, which can remain dormant or “sleep” in your body for long periods and then reappear.


Who is at risk for molluscum contagiosum infection?

Both children and adults alike can be infected by the virus. It is common amongst young children who may spread the virus through playing with each other especially at school.

In adults, it is more commonly spread through sexual contact due to direct skin to skin contact.

Some people are more at increased risk for getting the disease and this include:

  • People with weakened immune systems (i.e. HIV-infected persons or persons being treated for cancer)
  • Atopic dermatitis may also be a risk factor due to frequent breaks in the skin. 
  • Malaysians have higher chances to get this infection because our climate is warm and humid.

How does molluscum contagiosum look like?

The lesions, known as Mollusca, are small, raised, and usually white, pink, or flesh-coloured with a dimple or pit in the centre also known as central umbilication.

Common locations for the molluscum contagiosum papules are on the face, trunk, and limbs of children and on the genitals, abdomens, and inner thighs of adults. These bumps are painless and can range in size from barely visible to several millimetres in size or larger and may range from few to many in number. In individuals with weakened immune systems, lesions may be far more widespread e.g. >100 lesions.


How is molluscum contagiosum diagnosed?

Molluscum contagiosum is diagnosed clinically by identification of the classic pearly skin bumps. If the diagnosis is in question, a doctor can confirm the diagnosis with a skin biopsy by removing a portion of skin and sending it for histopathological examination. If the lesions look atypical, skin scraping of a bump may also be useful.


How is molluscum contagiosum treated?

Various treatment methods available include:

  • Radiofrequency Surgery

It can simultaneously cut and coagulate tissue without applying any physical pressure. With this new technique, the risk of scarring, bleeding and damage to the surrounding tissues are much lower compared to the conventional method. It is a safe, rapid and effective method. Plus, with the application of local anaesthesia, it will be more or less painless.

  • Podofilm or imiquimod topical cream application

The efficacy of topical treatment may vary.

  • Liquid nitrogen / Freezing

This type of method requires a special device that releases liquid nitrogen into your skin. This will freeze the wart and later it will peel off by itself.

Molluscum contagiosum is self-limiting. Most infections will clear by itself in 6-12 months.

However, treatment is recommended for:

  • Lesions around the genital or perianal region
  • If lesions are large 
  • Cosmetic purposes
  • In immunocompromised individuals with extensive lesions 

How can you avoid or keep it from spreading?

  • See your doctor

If you are concerned about any skin lumps or bumps and think you think are molluscum contagiosum, it is best to hold off attempting to treat it yourself (this may worsen the infection) 

  • Wash your hand

The best way is to follow good hygiene (cleanliness) habits and keep your hands clean 

  • Don’t scratch or pick at molluscum lesions

It is important not to touch, pick, or scratch skin that has lesions, that includes not only your own skin but anyone else’s. Picking and scratching can spread the virus to other parts of the body and makes it easier to spread the disease to other people too.

  • Cover the Molluscum lesion

Molluscum lesions should ideally be covered to reduce the risk of transmission (example covered with clothing, plaster or a bandage so that others do not touch the lesions and become infected. 

  • Don’t share personal items 

Avoid sharing unwashed clothes, hair brushes, wrist watches, or other personal items. 

  • Be careful during sports activities

People with molluscum should not take part in contact sports like wrestling, basketball, and football. Plus, activities that use shared gear like helmets, baseball gloves and balls should also be avoided unless all lesions can be covered.


What are the problems of Molluscum if you don’t get it treated?

Molluscum contagiosum is a benign lesion and is self-limiting. However, as long as the lesion is there, the risk of spreading to other parts of the body and to other people is high. Plus, if you scratch at the lesion, accidentally or not, this can result in scarring and secondary bacterial skin infections. Furthermore, I would advise against self-treatment by scraping or scooping to remove the lesion as this can cause scarring or spread to other body parts.

Next read: Herpes Management & Treatment

 


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