2.1.6 Molluscum Contagiosum

Grading & Level of Importance: A




Water warts; molluscum verrucosum; dell wart. 


Superficial viral infection of the skin.

Aetiology & Pathogenesis

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

Signs & Symptoms

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. 

Laboratory & other workups

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. 

Differential diagnosis

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

Prevention & Therapy

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

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