Makindo Medical Notes

Related Subjects: |Nikolsky's sign |Koebner phenomenon |Erythema Multiforme |Pyoderma gangrenosum |Erythema Nodosum |Dermatitis Herpetiformis |Lichen Planus |Acanthosis Nigricans |Acne Rosacea |Acne Vulgaris |Alopecia |Vitiligo |Urticaria |Basal Cell Carcinoma |Malignant Melanoma |Squamous Cell Carcinoma |Mycosis Fungoides (Sezary Syndrome) |Xeroderma pigmentosum |Bullous Pemphigoid |Pemphigus Vulgaris |Seborrheic Dermatitis |Pityriasis/Tinea versicolor infections |Pityriasis rosea |Scabies |Dermatomyositis |Toxic Epidermal Necrolysis |Stevens-Johnson Syndrome |Atopic Eczema/Atopic Dermatitis |Psoriasis

The lesions are small, skin-coloured papules with central umbilication.

About

• Molluscum contagiosum is caused by a DNA poxvirus
• Most commonly seen in children and harmless
• Contagious and most commonly seen in children and young adults

Clinical

• Picked up via close personal contact incubation period of a few weeks
• There are small pearly topped papules with a central depression (punctum).
• Usually 2-6 mm across but can be larger than this, up to 10 to 20 mm
• Koebner phenomenon is seen where the lesions appear along with sites of trauma
• Widespread Molluscum especially on the face of an adult should raise the question of HIV infection
• More common and extensive in people who have atopic eczema

Investigation

• Skin biopsy needed rarely
• HIV test in selected patients

Management

• Usually goes away by itself, taking between 6 and 18 months to do so. Otherwise, treatment is usually to stimulate an inflammatory response through direct trauma or cryotherapy.
• In HIV positive patients they usually resolve on the initiation of HAART

Local treatments

• Liquid nitrogen (cryotherapy) by the general practitioner or dermatologist at intervals until they are clear.
• Spots can be scraped off with a sharp instrument (curettage) after local anaesthetic injection by the general practitioner or dermatologist.
• Eye specialists can deal with spots on the eyelids.
• Imiquimod has been used for molluscum contagiosum, but it is not licensed for the condition and most research studies have shown that it is not effective.

Prevention

• You should make every effort not to pass the infection on to others, particularly those in your family. Stick to your own towel, flannel, clothing and bedding.
• However children with Molluscum contagiosum need not be kept off school, nor should they be barred from swimming, etc.

Revisions