Molluscum contagiosum
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- Localization. Trunk and extremities
- Erythematous lesion? Non-erythematous lesion
- Evolution time. Chronic: more than 2 weeks
- Skin lesion. Raised: papule, plaque or nodule
- Surface texture. Normal/smooth
- Edges Well defined and regular
- Color. Skin color: no color change
- Distribution of lesions. Discreet/isolated injury: 1 to 5 injuries, Multiple widespread/scattered lesions
- Associated symptoms.
- Additional information.
Brief information
- Molluscum contagiosum is a chronic infection with the molluscum contagiosum virus (MCV) that manifests on the skin in the form of firm, dome-shaped papules 2 to 5 mm in diameter, with a shiny surface and a central indentation or umbilication.
- Occasionally, it may appear as a polypoid shape with a stalk-like base.
- Itching may be present or absent; Inflammation of the lesions may occur.
- More prevalent in children between 2 and 5 years old.
- It also occurs in adolescents; sexually active adults; and immunocompromised.
- In children, molluscs are located on the face, trunk, limbs and axillary areas. The palmar and plantar regions are spared.
- In sexually transmitted forms, lesions are observed mainly in the anogenital region, abdomen and inner thighs.
- In immunocompromised people, molluscum contagiosum can have extensive manifestations.
- It is a benign condition, with generally spontaneous resolution.Most molluscum contagiosum lesions resolve without scarring.
Differential diagnosis
- Keratoacanthoma
- Lichen planus
- Epidermal cyst
- Vulgar wart
- Milia
Treatment
- Molluscum contagiosum is a benign, self-limited condition, although spontaneous resolution of the lesions can sometimes take several months (6 to 12 months, in rare cases 3 to 5 years).
- Treatment depends on the patient’s (or parent’s) preferences:
- early treatment in immunocompromised patients should be considered;
- sexually active adolescents or adults benefit from treatment to prevent transmission to third parties;
- in immunocompetent children, treatment is optional.
- Treatment options include:
- Physical removal: cryotherapy or curettage;
- Topical treatment: podophyllotoxin, apply to the lesion every 12 hours for 3 consecutive days. Repeat cycle for 4 weeks.
- Other options (with less evidence) include: potassium hydroxide; imiquimod.