Molluscum contagiosum is a common infection in children and young adults and is usually acquired through direct skin-to-skin contact. Diagnosis is clinical in the majority of cases.
Lesions appear as umbilicated, pearl-like, smooth papules. At least one third of patients will develop symptoms of local erythema, swelling, or pruritus.
Immunocompromise and underlying skin disease, particularly atopic dermatitis, increase the risk of molluscum infection.
Anogenital molluscum should prompt a full sexual health screen.
Most molluscum contagiosum infections require no treatment and resolve spontaneously.
This condition is caused by the molluscum contagiosum virus, a ubiquitous poxvirus that escapes immune destruction for months to years. Lesions are cutaneous (less commonly mucosal). They appear as pearl-like, smooth papules, which are umbilicated. Molluscum lesions display characteristic intracytoplasmic inclusion bodies (referred to as molluscum bodies or Henderson-Patterson bodies) on histology. Lesions are generally caused via skin-to-skin or fomite contact in children, and often by sexual transmission in adults.
History and exam
Key diagnostic factors
- presence of risk factors
- pearly papule with a central dell
Other diagnostic factors
- surrounding erythema
- facial or groin distribution of lesions
- atopic dermatitis
- sleep disturbance
- close contact with an infected individual
- sexual contact with an infected individual
- atopic dermatitis
- tropical climate
Investigations to consider
- curettage biopsy
- haematoxylin and eosin staining
- full sexual health screen including HIV test
- Deep fungal infection (Cryptococcosis and Penicillium marneffei)
- Herpes simplex virus
- UK national guideline for the management of genital molluscum in adults
- 2020 European guideline on the management of genital molluscum contagiosum
- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer