Molluscum Contagiosum

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Basics

Description

Molluscum contagiosum is a common, benign, viral (poxvirus) skin infection, characterized by small (2 to 5 mm), waxy white or flesh-colored, dome-shaped papules often with central umbilication. Lesions contain a cheesy grayish white material. Molluscum contagiosum is highly contagious and spreads by autoinoculation, skin-to-skin contact, sexual contact, and shared clothing/towels. Molluscum contagiosum is a self-limited infection in immunocompetent patients but can be difficult to treat and disfiguring in immunocompromised patients.

Epidemiology

Prevalence
  • 1% in the United States, occurring mainly in children 2 to 15 years and sexually active young adults
  • 5–18% HIV population

Etiology and Pathophysiology

  • DNA virus; Poxviridae family
  • Four genetic virus types, clinically indistinguishable
  • Virions invade and replicate in cytoplasm of epithelial cells causing abnormal cell proliferation.
  • Genome encodes proteins to evade host immune system.
  • Incubation period: 2 to 6 weeks
  • Time to resolution: 6 to 24 months
  • Not associated with malignancy
  • No cross-hybridization or reactivation by other poxviruses

Risk Factors

  • Skin-to-skin contact with infected person
  • Contact sports
  • Swimming
  • Eczema, atopic dermatitis
  • Sexual activity with infected partner
  • Immunocompromised: HIV, chemotherapy, corticosteroid therapy, transplant patients

General Prevention

  • Avoid skin-to-skin contact with host (e.g., contact sports, sexual activity).
  • Avoid sharing clothing and towels.

Commonly Associated Conditions

  • Atopic dermatitis
  • Immunosuppression medications: corticosteroids, biologics, chemotherapy, etc.
  • HIV/AIDS

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