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Molluscum Contagiosum

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MOLLUSCUM CONTAGIOSUM

Definition:

 Common, benign viral skin disorder consisting of small umbilicated


papules which tend to occur on the face, trunk and extremities in children
and on the groin and genitalia in adults
 Molluscum contagiosum is a cutaneous viral infection caused by a
poxvirus

Causes:

 DNA virus of the poxvirus group


 Molluscum contagiosum is a cutaneous viral infection caused by a
poxvirus, Molluscipoxvirus
 Humans are the only known source of the virus, which is spread by direct
contact, including sexual contact, autoinoculation, or from contaminated
fomites

Signs and symptoms:

 Discrete pearly to flesh colored firm papules


 Diameter 2 to 6 mm (rarely giant nodules up to 3 cm occur)
 Usually grouped in one or two areas
 Centrally umbilicated with erythematous base
 Lesions can be pruritic or tender
 Beneath umbilicated center is white curd-like core
 Distribution: Anywhere. Predilection for face, trunk and extremities in
children and groin and genitalia in adults.

Treatment

 Molluscum contagiosum infection is usually self-limited, with the disease


duration quite variable, lasting several weeks to several years.
 Lesions can regress spontaneously, but treatment may prevent
autoinoculation and spread to other individuals.
 Chemical or physical destruction is commonly used to treat molluscum.
 Chemical treatments include cantharidin (0.7% in collodion), salicylic
acid, lactic acid, and tretinoin.
 Physical destruction using liquid nitrogen cryotherapy or removal of the
central core of each lesion usually results in resolution.
 EMLA (eutectic mixture of local anesthetics) cream, a topical anesthetic,
may be applied 60+ minutes to 2 hours prior to needle extraction or
curettage.
 Scarring is rare, but may occur spontaneously or secondary to treatment.
 Cantharidin 0.9% solution with equal parts acetone and flexible
collodion: apply topically one to three treatments every 7 days or until
resolution
 Podophyllin (podofilox 0.5%): apply topically q 12 hrs for 3 days,
withhold for 4 days; repeat 1 week cycle up to four times until resolved
 Trichloroacetic acid (50-80%): apply and cover with bandage 5-6 days
 Tretinoin 0.1%: topically q12h for 10 days or until resolution of lesions
 Imiquimod cream - 1% or 5% applied topically 1 or 2 times daily 3
times a week for 4-16 weeks
 Podophyllotoxin cream - 0.5% applied topically daily for up to 4 weeks
 Potassium hydroxide - 5% or 10% applied topically twice daily for up
to 6 weeks

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