MOLLUSCUM CONTAGIOSUM - a patient's guide
Abstract
What is Molluscum Contagiosum?
This spotty lesion is caused by a wart-like virus called the molluscipoxvirus and is mostly harmless to children. This is a different virus to those which cause ordinary warts. It has an incubation period of 2 to 8 weeks and will usually disappear over 9 to 12 months by itself without any scarring so can be left alone quite safely.
Usually it occurs as multiple lesions. Sometimes they grow more easily on skin affected by eczema and can last longer on eczematous skin. Eczema treatment can be continued in the presence of molluscums.
Transmission to other parts of the same child's skin or to another person, is by direct close contact. This makes the lesions more common where skin touches skin such as in the armpit. They have an easily recognised appearance being round with a central dimple. Underneath the dimple is a white cheesy substance which contains the virus.
Unlike warts, molluscums do not occur on the palms or soles.
Molluscum contagiosa can also occur in adults as a sexually transmitted disease. In some immune deficient states such as AIDS, molluscums can grow very large.
Treatment:
In children it is quite acceptable to avoid any specific treatment and wait for spontaneous remission. However there is a small risk of a molluscum becoming secondarily infected with bacteria. This will be obvious because the lesion will become red and sore.
The goal of treatment is to remove or ablate the central core of the lesion.
The simplest treatment is adhesive tape stripping. This usually only works with larger riper lesions. A strip of clear sticky tape is applied at bedtime and stripped off the following day hopefully removing the core. The core of the lesions contains the infective bit so dispose of the used tape very carefully and do not touch the sticky side.
Phenol (an acid like chemical) applied with a sharp toothpick to the central dimple is another treatment. This is put on each molluscum each night. Sometimes infection can occur.
Other wart-treatment chemicals can be applied by your doctor e.g. trichloroacetic acid or cautery can be used with an electric needle or cryo-cautery with liquid nitrogen but these treatments can cause pain and scarring.
Immuno-stimulation can be used with the drugs cimetidine or lamprene. It is better to avoid drugs in children unless there are huge numbers of molluscums.