Viruses – Molluscum Contagiosum

October 8th, 2010

Molluscum Contagiosum is one of the more common skin diseases I encounter in both my The Woodlands dermatology and Conroe dermatology offices.  It is a poxvirus that is spread by direct skin to skin contact, especially wet skin.  Swimming pools are a common place where the infection is transmitted.  There are four types of Molluscum virus MCV-1, MCV-2, MCV-3, MCV-4.  Most all cases are caused by MCV-1 and patients with HIV are most commonly infected with MCV-2.  Unlike HPV, the different types of MCV are almost clinically identical and can infect any anatomic region of the body.  Molluscum is mainly found in children but can be seen in immunosuppressed patients and sexually active adults.  The lesions of Molloscum are small flesh colored papules with a characteristic central umbilication.  Occasionally, eczema forms around Molluscum, which appears as a red scaly itchy rash.  It is important to treat all of the lesions as they can spread to other parts of the body via auto inoculation.  I treat most of my patients who have Molloscum with liquid nitrogen.  Most patients are cured in one or two visits.  Unlike warts, Molluscum does not lay dormant but can be completely eradicated.  In some patients, topical treatments such as Aldara or tretinoin cream can be used but these take much longer to work and may not have any efficacy in some patients.  In young children who cannot tolerate cryotherapy, the parents can perform a modified incision and drainage at home.  The Molluscum are cleansed with isopropyl alcohol and a sterile diabetic needle is used to open the top of the lesion.  Duct tape is applied to the lesion and as it is pulled away, the central infectious core is extracted on the tape.