Dr. med. Dirk Manski



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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

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.





Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



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


  Deutsche Version: Molluscum contagiosum: virale Infektion der Haut.