Molluscum contagiosum (MC) refers to a common skin and mucous membrane infection due to a poxvirus. Any part of the child’s body can be affected with the most affected being the face, neck, arms, armpits, and hands. Other parts include the abdomen, legs, and private parts, but rarely on the soles or palms. The nodules are often firm and smooth, with sizes ranging from that of a pinhead to a pencil eraser. A small dimple usually forms on the top of each lesion.
These warts develop in clusters, usually of approximately 30 molluscum. MC is not serious and typically goes away within six to 12 months without scars. Some, however, may take about four years to resolve. It is most prevalent in children, especially those aged one to four years, although adults may also be affected. Adults likely to be affected are those with low immunity, such as AIDS patients or those undergoing steroid or chemotherapy treatment.
Causes & Risk Factors
A poxvirus called molluscum contagiosum virus transmits MC through skin-to-skin contact. Other children get infected when they touch objects contaminated by the virus such as soft toys, flannels, towels, etc. The infection can also occur when the child touches the skin of a person with MC. From the site of infection, the rash spreads to other parts of the body.
Nevertheless, most people are immune to the poxvirus, hence, they do not develop MC. Intimate sexual contact, though it may not apply to children, can cause MC.
Signs & Symptoms
The most prominent MC symptom is the numerous tiny, firm, pearly, raised nodules on the skin with a small pimple at the center. The warts may be sore, swollen, itchy, and/or colored. They are pink on white skin and beige on darker skin. Often, the lesions form clusters and spread to different parts of the body. They do not measure more than 0.5cm across, although they can grow bigger.
A thick, yellow white, highly infectious substance emerges when the wart ruptures or is squeezed. Hence, the nodule should never be squeezed because the infection will spread to other parts of the body. These spots are also itchy, painless, and can sometimes come with dry, cracked skin around them. Children will have about 30 warts clustered together, while those with a compromised immune system tend to have more. Common areas where these nodules lodge include behind the knees, on the groin, and in the armpit.
Eye problems such as keratitis or conjunctivitis may occur, leading to photophobia (sensitivity to light) and soreness. The eyes may also develop pain, swelling, or redness. Though not common, bumps may form on the outer regions of the eyeball and on the eyelid.
Diagnosis of MC is made through physical examination as the nodules have a unique appearance. The child's health history is also essential.
Treatment in children is not recommended because the disorder tends to resolve on its own within a year or so. Sometimes treatment of these warts when using things such as using liquid nitrogen, may cause pain. Some treatment methods end up burning the child's surrounding skin. In fact, children hardly notice the problem with cosmesis, and the lesions do not affect quality of life. They continue with activities such as swimming, school, sports, etc., without being psychologically affected. Treatment is also not recommended for children because allowing the nodules to resolve on their own lessens scar formation. Besides, the infection causes no other symptoms apart from the nodules.
Sometimes treatment may be required in older children and adults if the warts cause trouble, appear unsightly, or spread very widely.
Health care professionals are yet to agree on the most effective liquids, creams, and lotions. Examples include hydrogen peroxide, benzoyl peroxide, iodine preparations, etc. People with immunosuppressed systems can use Imiquimod cream.
Cryotherapy, a freezing method using liquid nitrogen, helps freeze the mollusca. A pulsed dye laser can also be used to blast the mollusca.
Prognosis & Long-Term Outlook
Infections can recur in the future if the child encounters the virus after recovery. Those who underwent treatment may have scars. Those with a compromised immunity may suffer from a secondary infection due to bacteria. They need treatment to stop further spread of the infection.
Prevention & Follow Up
The possibility of transmitting the virus to other people during everyday activities is slim. Children can attend school and participate in other activities like they normally do. Preventive measures may include:
- Avoiding sharing clothes, bathwater, soft toys, towels, etc
- Avoiding scratching the wart to prevent the rash from spreading to other parts of the skin
- Avoiding skin-to-skin contact with those infected. The infected can cover the affected parts with clothing
Sexual transmission in adults can be prevented with a condom during intercourse