2.1.6 Molluscum Contagiosum

1E76 

Water warts; molluscum verrucosum; dell wart. 

Superficial viral infection of the skin.

Common. 12-14 episodes per 1000 children per year in Europe. Likely to be similar world-wide. Peak infection between 1-4 years of age. Affects more frequently children with atopic dermatitis.

Causative agent: molluscum contagiosum (epidermotropic pox) virus, transferred between humans by direct contact, usually in children or sexual partners. 

Single or multiple dome-shaped papules with a central dell, usually skin-coloured, often translucent, may be red. Typically not itchy or painful.

Normally clustered; may be linear along excoriations. Children: usually extragenital. Sometimes solitary, disseminated and giant in adults. 

Nil.

Not required. 

Only required in cases of diagnostic difficulty. Lobulated endophytic hyperplasia. Basophilic intracytoplasmic inclusions in keratinocytes. 

May spread, particularly in the setting of atopic dermatitis or immunosuppression/HIV infection. Spontaneous resolution may occur within weeks to 18 months. 

Secondary bacterial infection; scarring (usually from treatments rather than the disease itself); rarely conjunctivitis or keratitis.

Usually clinical; expelling of molluscum bodies. 

Plane warts; condylomata accuminata in ano-genital area, basal cell carcinoma in solitary lesions in adults. 

Despite spontaneous regression, therapeutic approaches such as 5% potassium hydroxide solution; destruction with curettage; cryosurgery for single or giant lesions; antiseptics if secondary infection.