Viral Infections

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Overview

Molluscum contagiosum (sometimes called molluscum contagium) is a benign viral infection of the skin. It most commonly affects children, but also occurs in adolescents and adults.

Cause

Molluscum contagiosum is caused by a poxvirus. It is spread by person-to-person contact and through casual contact with contaminated objects, such as shared towels and sports equipment. In adults, the infection is often transmitted sexually. Scratching the lesions can spread the virus to surrounding skin.

Signs and Symptoms

The skin lesions begin as tiny papules (bumps) and reach an average size of 6 millimeters. They are smooth, sometimes shiny and pink with a central dimple, and usually appear in groups. Usually there are less than a couple dozen lesions, but in some cases there can be a hundred or more. An irritated skin rash can develop around the papules. Individual lesions may heal without treatment after a few months, but the general outbreak can last anywhere from 6 months to 3 years.

Diagnosis

The lesions are distinctive and clinical diagnosis is typical. The diagnosis can be confirmed with a skin scraping and microscopic evaluation.

Treatment

In children, the infection is usually self-limiting and often resolves in about a year. In patients with AIDS, who are particularly susceptible to molluscum, the eruption can be resistant to treatment.

Treatment modalities range from painless medicated drops applied in the physician's office, to liquid nitrogen (a very cold spray that freezes the papules), to scraping off the top of the lesions. Some people respond to applying a prescription medication, tretinoin (Retin A®, Avita®), daily to each papule with a toothpick. A prescription immune-stimulating cream, imiquimod (Aldara®), has been shown to be effective as well.

Prevention

The only preventive measure is avoiding contact with infected skin and contaminated objects.

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