Molluscum Contagiosum

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Introduction

  • A common infection caused by a large epidermotropic pox virus
  • Common in children
  • Spread by direct human to human contact
  • In adults it is often transmitted during sexual intercourse

Clinical features

  • 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

  • Secondary bacterial infection

Investigations

  • Histopathology of the expressed pasty core

Treatment goals

  • 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

  • Avoid direct skin contact with an infected person