Molluscum contagiosum

Molluscum contagiosum basics for Undergraduate learning

1. MOLLUSCUM CONTAGIOSUM Dr.T.V.Rao MD

2. Molluscum contagiosum It is caused by a DNA poxvirus called the molluscum contagiosum virus (MCV). MCV has no nonhuman-animal reservoir (infecting only humans). There are four types of MCV, MCV-1 to -4; MCV-1 is the most prevalent and MCV-2 is seen usually in adults. The virus that causes molluscum is spread from person to person by touching the affected skin. The virus may also be spread by touching a surface with the virus on it, such as a towel, clothing, or toys.

3. What is Molluscum Molluscum is a common, harmless skin growth caused by a type of virus that lives on the outer most layers of the skin (epidermis).

4. Molloscum contagiosum Children and young adults are infected Present with pearly white wart like Normal sections show large 20 – 30 micron sized Eosinophilic hyaline inclusion bodies are seen. Molluscum bodies contain large number of virus particles in a protein matrix. Dr.T.V.Rao MD 4

5. Lesions begin as small (3 to 6 mm) papules that are smooth, flesh-colored domes with a central dimple. Inside the papule is a white, curd-like core that can be easily expressed. Lesions can occur anywhere on the skin and mucous membranes, but are usually grouped in one or two areas. Occasionally, they may be widely disseminated. Typically fewer than 20 lesions are present, but some individuals may have hundreds. The head, eyelids, trunk, and genitalia are most commonly affected, the genitalia being the predominant site in adults. The lesions are characteristically asymptomatic, but a few patients may complain of itching or may develop an eczematous reaction around the lesions. Molluscum Contagiosum

6. Incubation period The time from infection to the appearance of lesions ranges from 1 week to 6 months.

7. Signs and symptoms Molluscum contagiosum lesions are flesh- colored , dome-shaped, and pearly in appearance. They are often 1–5 millimetres in diameter, with a dimpled center.They are generally not painful, but they may itch or become irritated. Picking or scratching the bumps may lead to further infection or scarring. In about 10% of the cases, eczema develops around the lesions. They may occasionally be complicated by secondary bacterial infecti ons.

8. Is it contagious? Yes. The virus is spread by skin to skin contact with a person who has molluscum or by touching a lesion on your own body and transferring the virus to another location on your body (autoinoculation). It is also possible to get molluscum by sharing towels or clothing with other people who have molluscum.

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14. Diagnosis Diagnosis is made on the clinical appearance; the virus cannot routinely be cultured. The diagnosis can be confirmed by excisional biopsy . Histologically, molluscum contagiosum is characterized by molluscum bodies in the epidermis above the stratum basale, which consist of large cells with: abundant granular eosinophilic cytoplasm (accumulated virions ), anda small peripheral nucleus.

15. There are many treatment options The treatment will depend on your age, health, where the bumps appear on your body, and other considerations .

16. Treatments that a dermatologist can perform in the office to treat Molluscum contagiosum include: Cryosurgery: The dermatologist freezes the bumps with liquid nitrogen.

17. Curettage Curettage: The dermatologist may use a small tool called a curette to scrape the bumps from the skin.

18. Laser surgery Laser surgery: A dermatologist uses a laser to target and destroy the bumps. This can be an effective treatment for people who have a weakened immune system

19. In AIDS Patients If a person has AIDS or another disease that weakens the immune system, the bumps will not go away without treatment — and the bumps can be a challenge to treat. Dermatologists often combine treatments to offer these patients some clearing. Complete clearing may not be possible.

20. Drugs to Treat Imiquimod : This medicine is applied to the bumps. Imiquimod helps your immune system fight the virus. This is strong medicine. It also is used to treat stubborn warts and some skin cancers. Retinoid or antiviral medicine applied to the skin: Patients apply this medicine to the bumps as instructed.

21. Outcome Molluscum contagiosum remains contagious until all of the bumps go away. If a person with a healthy immune system opts not to treat the bumps, the bumps will eventually go away on their own without leaving a scar. After treatment, a person may get new bumps for as long as 6 months. Most people have complete clearing in 2 to 4 months.

22. Program Created by Dr.T.V.Rao MD for Basic learning on Infectious diseases Email [email protected]