MOLLUSCUM

CONTAGIOSUM
 Molluscum contagiosum
• Molluscum contagiosum is the infection of the skin caused by
the Molluscum contagiosum virus, which belongs to the same
family as the pox.
• It is a common infection but is contagious. It causes raised
nodules on the epidermal layer of the skin.
• It is classified as a chronic infection and can be resolved in
anywhere between six to nine months, generally.
• You may not see symptoms of infection for up to 6 months.
These symptoms usually take between 2 and 7 weeks to show
from the moment you acquire the molluscum contagiosum virus.
Epidemiology and transmission 
• Molluscum contagiosum is commonly seen in children but can also occur in adults.
The virus is transmitted through direct skin contact or fomites.
• Molluscum contagiosum infection in the genital region may result from
transmission during sexual activity. 
 Clinical features
• Molluscum contagiosum most commonly presents as single or multiple small,
skin-colored papules with central umbilication
• Immunosuppressed individuals have an increased risk for larger lesions and more
widespread disease 

 "giant lesions" on the face of a

patient with acquired
immunodeficiency syndrome.
 Clinical features
• Epidermal surfaces of limbs, face, chest and trunk
• The lesions or raised nodes can be itchy but do not pain in general cases. 
• The lesions or nodes are small in size, with a diameter of 2 – 5 millimetre each. 
• The unique character of this infection is that the lesions and nodes have a dimple
lie resemblance in the central area.
• In the initial stages of the infection, the lesions or nodes have a dome-shaped
structure and are the colour of flesh, but during the course of time, change in
appearance to become more soft with a light or white shade at the centre, with
the presence of a waxy, almost semi-solid material.
• The spots are about 2 to 5mm wide and usually appear together. They are raised
and dome-shaped with a shiny white dimple in the middle.
• Children with the infection often get spots on their body and in or around folds of
skin (groin, behind the knee and armpits).
• In adults where the infection is spread through sexual contact, spots may be
around the lower tummy, genital area and thighs.
• Someone with a weakened immune system may get spots on the face, around the
eyes or have many or bigger spots.
 Diagnosis 
• The diagnosis of molluscum contagiosum typically is based upon the clinical appearance
of skin lesions.
• Biopsy can confirm the diagnosis when necessary. Histopathologic examination of a
lesion of molluscum contagiosum reveals eosinophilic cytoplasmic inclusion bodies
within keratinocytes 

Eosinophilic cytoplasmic
inclusion bodies are
visualized on
hematoxylin and eosin
staining of a molluscum
contagiosum lesion.
Differential diagnosis
Decision to treat
• The spots caused by molluscum contagiosum are usually harmless and should
clear up within 18 months without needing treatment.
• The lesions or nodules completely disappear from the epidermal surface.
• People with a healthy immune system do not require a medical intervention unless
it is a complicated or very advanced stage of the infection.
 Treatment 
• A medicine that irritates the sores, such as retinoic acid or benzoyl peroxide
• A medicine that causes blisters (cantharidin), which lifts off the bumps
• Surgically scraping them off
• Freezing the spots off with liquid nitrogen (cryotherapy)
• Laser therapy, which might be an option for people with a weakened immune system
• Oral cimetidine At a dose of 30–40 mg/kg/day, oral cimetidine has been used in
children and adults.
• Topical therapy Podophyllotoxin cream (0.5%) is reliable as a home therapy for men
but is not recommended for pregnant women because of presumed toxicity to the
fetus.