2.1.7 Molluscum Contagiosum

Grading & Level of Importance: A

ICD-11

1E76 

Synonyms

Water warts; molluscum verrucosum; dell wart. 

Definition

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.

Localisation

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

Laboratory & other workups

Not required. 

Dermatopathology

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

Course

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

Complications

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

Diagnosis

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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