Molluscum contagiosum, a contagious infection

Common in young children, between 2 and 10 years old, MOLLUSCUM CONTAGIOSUM is contagious by direct contact or by sharing soiled objects (towels, bath sponges, especially in swimming pools, etc.). In adults, Molluscum can be transmitted sexually (by skin-to-skin contact). It is then advisable to do an assessment to look for other STDs.

The spread of lesions is promoted by self-inoculation (e.g. by scratching) or shaving in adults. A warm, humid environment is conducive to infections and their spread.

The incubation period varies between 2 weeks and 6 months after contact.

Clinical aspect

Molluscum Contagiosum lesions are small, firm, hemispherical, centrally umbilicated, white or flesh-colored papules 1 to 5 mm in diameter.

Their central umbilication, which when pressed releases a whitish material corresponding to altered epidermal cells, is very characteristic.

They are found isolated or in clusters and the locations are varied at the skin level.

They most often appear on the face, eyelids, neck, trunk, arms (inside of the elbow), buttocks, thighs or on patches of eczema.

In adults, in the context of an STD, they are found on the pubis, genitals, buttocks or inner thighs. Unlike condylomas, mucosal involvement is rare.

The clinical appearance is generally very suggestive and allows them to be easily identified. It is only in the presence of certain solitary, very large, non-umbilicated, very inflammatory elements that a histological examination may be necessary.

The differential diagnosis can be made between:

Chickenpox lesions

Microvesicles at the very beginning may simulate Molluscum Contagiosum but quickly evolve into crusted and pruritic lesions. There are also general signs.

Flat wart

Small flattened papules that are mainly located on the face, neck, chest and back of the hands without umbilication.

Warty papilloma

Frequent filiform viral skin lesions on the face (beard and eyelids)

Sebaceous adenoma

Very numerous small tumors, the size of a grain of millet to that of a large chickpea, located around the nose and mouth. These adenomas appear in late childhood and are often familial.

Condyloma

Small growths of a few millimeters reminiscent of the texture of skin warts. Located on the skin and/or mucous membrane, they sometimes form only small pink or brownish elevations.

Acrochordon

Benign skin lesion, filiform or bell-shaped, ending in warts.

LEARN MORE

T. Jansen, R. Romiti – Evaluation of the efficacy and tolerability of 5% Potassium Hydroxide Solution in the treatment of Molluscum contagiosum in Childhood – Clinic of Dermatology – Sao Paulo – Brazil – Akt Dermatol – 2007

Management of molluscom contagiosum

Lack of treatment

Spontaneous healing occurring within a few months, usually 6 months to 2 years

Physical and drug treatments

• To be applied locally to each Molluscum Contagiosum lesion: 5% or 10% potassium hydroxide solutions, the effectiveness of which has been proven.
• Curettage: Probably the most common treatment is cutting out the molluscum with a curette, but this procedure is somewhat painful. Curettage requires the use of a small, sterile scalpel that is extremely precise (in expert hands) in removing only the infected skin.
• Cryotherapy: Cryotherapy involves burning the lesions with nitrogen but this method is quite painful.
• Electrocoagulation: Electrocoagulation destroys lesions using an electric current. However, this treatment can leave unsightly scars. The dermatologist may also use laser photovolatilization.
• Others: Local applications of retinoid cream or corrosive substances are more rarely recommended.

Tips to prevent the proliferation of molluscum contagiosum

• Temporarily avoid the proximity of infected children to others during bathing, pool activities or when practicing contact sports.
• Avoid sharing towels used by infected patients.
• It is not recommended to scratch molluscum as this encourages its spread.
• Avoid sexual contact while you are a carrier of molluscum.
• Molluscum contagiosum can take 2 to 3 months to develop, but symptoms may appear in less than a week or as late as 6 months.

If in doubt, do not hesitate to speak to your doctor.