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Molluscum Contagiosum: Virus, Diagnosis, and Treatment
Definition
Molluscum contagiosum is a viral infection of the epidermis with pearly papules (CDC Guidelines, 2021).
Epidemiology of Molluscum Contagiosum
Risk groups for molluscum contagiosum are children, adolescents, sports with skin-to-skin contact, sexually active persons, and patients with immune deficiency.
Etiology of Molluscum Contagiosum
Molluscum contagiosum virus (MCV):
DNA virus of the pox group. Incubation period 2–7 weeks. Transmission from human to human via skin-to-skin contact or inanimate vectors (e.g., towels).
Signs and Symptoms
- Isolated or grouped dome-shaped skin-colored papules (1–5 mm) with a central umbilication.
- Typical manifestations are the face, trunk, axillae, and genital region.
- Papules can be expressed by lateral pressure (molluscum bodies).
- Generalized manifestation is possible with immunodeficiency.
Diagnosis
Diagnosis is possible with inspection only; a biopsy is necessary for untypical lesions, which show virus-infected cells with DNA-containing inclusion bodies.
Treatment of Molluscum Contagiosum
Natural course:
Molluscum contagiosum is usually a self-limiting disease that lasts several months to two years. Observation without active treatment is possible. Widespread and persistent disease is possible in patients with immunodeficiency (HIV).
Topical therapy:
Local application of cantharidin, imiquimod, podophyllotoxin, and numerous other substances have been effectively used against molluscum contagiosum. Disadvantages include side effects and high cost.
Surgical therapy:
Curettage followed by iodine-containing disinfection. Alternative techniques: cryosurgery or laser treatment. Disadvantages include pain and scarring.
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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 Infections (STI) Treatment Guidelines,” 2021. [Online]. Available: https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf
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.
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