What is molluscum contagiosum!

The molluscum contagious is caused by a DNA virus that is an unclassified member of the Poxviridae family.  It affects mainly infants and young children under 10 years of age.  Adolescents and adults are less likely to be infected.  Contagious molluscum is more common in warm climates than in cool climates and in overpopulated areas. 
Molluscum contagious manifests itself in the form of clusters of small round papules. Papules range in size from 1 to 6 mm and can be white, pink or brown. They often have a waxy, shiny appearance. When enlarged, a central umbilical-like depression (indentation) appears on the papule, and when pressed, white contents are released. There can be from several to hundreds of papules on the skin. They mostly occur in warm, moist areas of the body, such as the armpits, behind the knees, in the groin, or on the genitals, and can also occur on the lips and occasionally in the mouth.
Usually, molluscum contagiosum is asymptomatic, but about 10% of patients develop eczema (irritation, dryness, redness) around the lesions. This is due to toxic substances produced by the virus or a hypersensitivity reaction to the virus.

How does infection occur?

Infection occurs in several ways:
- Direct skin-to-skin contact.
- Indirect contact through shared towels or other items.
- Transfer of the virus to healthy skin by damaging other elements (e.g., shaving, scratching).
- Sexual transmission (in adults).
Transmission of molluscum contagiosum is more likely in humid conditions, such as when people bathe or swim together. The incubation period (the time from infection to the formation of the first rash) is usually about 2 weeks, but can be up to 6 months.

The molluscum contagiosum tends to be more numerous and persists longer in children who also have atopic dermatitis due to deficiencies in the skin barrier. It can also be common and cause concern in patients with human immunodeficiency virus (HIV) or those with other causes of insufficient immune function.

Treatment.

There is no single ideal treatment for molluscum contagiosum, as it is currently impossible to kill the virus/ that causes it. In many cases, no specific treatment is needed. Most of the time, the infection resolves on its own, so observation tactics are used, especially in children, for whom removal of the elements can be emotionally draining. The overall goal of most treatments is to accelerate the disappearance of the elements, reduce the localized inflammatory response, and prevent the spread of the molluscum.
In adults, who are more motivated to treat the lesions, cryotherapy or curettage (scraping with special tools) of individual lesions is effective and well tolerated.

Can a molluscum contagiosum reoccur?

Recurrence (re-emergence) occurs in 35% of patients after initial clearance. The causes of these recurrences are unknown. They can mean re-infection, exacerbation of the current disease, or new lesions occurring after a long latent period.
In most cases, the diagnosis is easy to make because of the characteristic clinical picture or during dermatoscopy. In rare cases, if the diagnosis is uncertain, a biopsy of the element can be performed.

Author: dermatologist Natalia Heinik