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