Molluscum Contagiosum
References: (Bikowski, 2004) (CDC Guidelines, 2006) (Smith and Skelton, 2002) (Ting and Dytoc, 2004) (Tyring, 2003).
Definition
Molluscum contagiosum is a viral infection of the epidermis with pearly papules.
Epidemiology of Molluscum Contagiosum
Risk groups for molluscum contagiosum: children and adolescents, sports with skin-to-skin contact, sexually active persons, patients with immune deficiency.
Etiology of Molluscum Contagiosum
Pathogen:
Molluscum contagiosum is caused by a DNA virus of the pox group. Incubation period 2–7 weeks. Transmission from human to human via skin-to-skin contact or via inanimate vectors (e.g. towels).
Signs and Symptoms
- Isolated or grouped dome-shaped skin-colored papules (1–5 mm).
- Manifestation at the face, trunk, axillae and genital region.
- Papules can be expressed by lateral pressure (molluscum bodies).
- Generalized manifestation can be possible due to immunodeficiency.
Diagnosis
When in doubt, a skin biopsy should be done (virus-infected cells with DNA-containing inclusion bodies).
Treatment of Molluscum Contagiosum
Drug Therapy
Cantharidin:
Cantharidin causes a blistering and inflammation of the skin; this heals the manifestion without scarring. Cure rate 90%. Side effects: blistering, local irritation.
Imiquimod:
5% cream 3× per week for 16 weeks. The immunomodulatory effect causes the release of interferon and tumor necrosis factor. Cure rate 35–85%, as shown in several randomized trials. The benefit of imiquimod is a lower rate of side effects. Disadvantages are the higher treatment costs and relapse rate.
Surgical Therapy
The papules are expressed by lateral pressure or removed with a sharp spoon followed by iodine desinfection. Alternative techniques: cryosurgery.
Prognosis of Molluscum Contagiosum
Molluscum contagiosum is usually a self-limiting disease, which lasts five months to five years (usually within nine months). Longer courses of disease are possible with immunodeficiency.
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References
- Bikowski 2004 BIKOWSKI, Jr.:
- Molluscum contagiosum: the need for physician intervention and new
treatment options.
In: Cutis
73 (2004), Nr. 3, S. 202–6
- Center for Disease Control and Prevention.:
- Sexually transmitted diseases treatment guidelines 2006.
in: MMWR
2006; 55 (No. RR-11): 1–93.
- Smith und Skelton 2002 SMITH, K. J. ; SKELTON, H.:
- Molluscum contagiosum: recent advances in pathogenic mechanisms, and
new therapies.
In: Am J Clin Dermatol
3 (2002), Nr. 8, S. 535–45
- Ting und Dytoc 2004 TING, P. T. ; DYTOC, M. T.:
- Therapy of external anogenital warts and molluscum contagiosum: a
literature review.
In: Dermatol Ther
17 (2004), Nr. 1, S. 68–101
- Tyring 2003 TYRING, S. K.:
- Molluscum contagiosum: the importance of early diagnosis and
treatment.
In: Am J Obstet Gynecol
189 (2003), Nr. 3 Suppl, S. S12–6
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Deutsche Version: Molluscum contagiosum: virale Infektion der Haut.
Last update:
Dr. med. Dirk Manski (E-Mail)