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Molluscum contagiosum

Molluscum contagiosum (also called water wart) is skin disease caused by the molluscum contagiosum virus (or MCV), a DNA poxvirus. This condition is commonly found in young children and affects the body, arms, and legs. It is spread through direct contact, saliva, or shared articles of clothing. more...

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In adults, molluscum infections are often sexually transmitted and usually affects the genitals, lower abdomen, buttocks, and inner thighs. In rare cases, molluscum infections are also found in the lips and mouth.

Symptoms

The symptoms of molluscum contagiosum infection include flesh-colored, pea-sized or smaller bumps (called lesions) with dimpled center that may itch, become irritated, tender or painful. In about 10% of the cases, eczema develops around the lesions.

In most patients, however, these wart-like lesions do not have noticeable symptoms. These lesions are prone to secondary bacterial infections, which may obscure or complicate the original condition.

The central waxy opaque core of the lesions contain the virus. In a process called auto-inoculation, the lesion breaks to release the virus which subsequently cause new lesions at a different part of the skin. Children are particularly susceptible to auto-inoculation, and may have widespread clusters of lesions.

Treatments

Molluscum contagiosum infections usually go away by itself within 6 months to 2 years, so that the condition may not warrant specific treatment. For mild cases, over-the-counter wart medicines, such as salicylic acid may shorten infection duration. A person can also use acne treatments, such as a mild or soft scrub when showering, or application of tretinoin cream (vitamin A acid).

Medical treatments for this condition include cryosurgery, where liquid nitrogen is used to freeze and destroy lesions, as well as scraping them off with a curette. Side-effects from these treatments include permanent discoloration and scarring. The topical blistering agent cantharadin applied by a doctor is sometime used in children as the previously mentioned treatments are painful. Pulsed dye laser treatment offers an effective and painless, but relatively expensive way to eliminate individual lesions.

Read more at Wikipedia.org


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Molluscum contagiosum - Pathology Clinic
From Ear, Nose & Throat Journal, 8/1/03 by Brenda L. Nelson

Molluscum contagiosum is a virus-induced epithelial hyperplasia produced by a DNA poxvirus. This common disease can be found on the skin and mucosal surfaces. It is acquired by direct contact with an infected individual or, less commonly, by contact with a fomite (e.g., clothing, towels, and toys); autoinoculation is common. Molluscum contagiosum is usually seen in children and young adults; immunocompromised persons are especially vulnerable to infection. Lesions predominantly arise on the skin of the face, neck, eyelids, trunk, and genitalia, as well as on the mucous membranes of these areas (as applicable). The incubation period averages between 2 and 7 weeks, although it can be much longer.

In most cases, the clinical appearance of molluscum contagiosum is diagnostic. Lesions appear as pink, smooth-surfaced, sessile, nontender papules that measure 2 to 6 mm in diameter. The central depression or umbilication has a white, waxy, curd-like core. Histologically, molluscum contagiosum exhibits a lobular proliferation of surface epithelium (figure 1); an aggregation of enlarged keratinocytes that are engorged with viral inclusions (molluscum bodies) can be seen in the center of the lesion (figure 2). Molluscumbodies have a homogenous, groundglass, eosinophilic appearance.

[FIGURE 1-2 OMITTED]

Although the clinical appearance is characteristic, molluscum contagiosum must be differentiated from verruca vulgaris (wart), herpes simplex, epidermal inclusion cysts, and tumors of the skin. Molluscum contagiosum is a self-limiting disease, although many patients ask for treatment. Curettage and cryosurgery are the most common means of treatment. There is also a variety of topical treatments that are employed, some with greater success than others.

Suggested reading

Hanson D, Diven DG. Molluscum contagiosum. Dermatol Online J 2003;9:2.

Whitaker SB, Wiegand SE, Budnick SD. Intraoral molluscum contagiosum. Oral Surg Oral Med Oral Pathol 1991;72:334-6.

From the Department of Pathology, Woodland Hills Medical Center, Southern California Kaiser Permanente Group, Woodland Hills, Calif.

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