What is molluscum contagiosum?
Molluscum contagiosum is a benign skin disease caused by a poxvirus. The virus enters through small breaks in the skin, and molluscum lesions start to appear after a period of incubation. Molluscum contagiosum only affects the skin and does not cause systemic or internal problems.
How to recognize molluscum contagiosum? Typically, molluscum contagiosum presents as small, shiny, flesh-colored or pink dome-shaped papules with an umbilicated center. Although they start as small papules, they may grow to the size of a pencil eraser. A white core may also be visible. Molluscum can appear anywhere on the body and commonly involves skin folds or areas of close skin-to-skin contact, such as the armpits and the back of the knee. They do not appear on the palms of the hands or soles of the feet.
How does it spread? The virus is spread by skin-to-skin contact and contact with items that can carry the virus. For example: • A person with molluscum can spread the virus to other body parts by touching a noninfected area after rubbing or scratching a lesion. • The virus can spread to another person through direct skin-to-skin contact, as with hugging or linking arms. • A person can get molluscum through fomites such as kickboards, towels and clothing.
OFFICE TREATMENT OPTIONS AT CHAMPS Pediatrics for molluscum and for warts.
Extraction of the core
Curettage
Cryotherapy with liquid nitrogen
Note: These are effective destructive measures that are often appropriate for older pediatric patients but may be uncomfortable or painful and hence are not always suitable for younger pediatric patients.
Cantharidin
Cantharidin is a chemical compound derived from a blister beetle that induces the formation of a vesicle when applied to the skin. It must be obtained from a compounding pharmacy. This can be an effective and well-tolerated treatment option when used with the appropriate application technique. Note: Because of the unpredictable nature of blister formation, use of this chemical should be restricted to the body, arms and legs and should not be applied to the face
AT-HOME TREATMENT OPTIONS No treatment
Molluscum will spontaneously resolve with time but may last several months to a couple of years. Treatment recommendations
Molluscum contagiosum will eventually resolve without treatment, although this can take several months to a few years. Given that molluscum is a benign skin condition and that it will likely spontaneously resolve, reassurance to the parents and a watchful-waiting approach is reasonable. As some lesions resolve, others may appear. It is also common for molluscum to become irritated with redness, pruritus and swelling. This represents a natural immune reaction against the virus that is seen before spontaneous involution. Treatment can help prevent the spread of the virus to other body parts or people.