Molluscum contagiosum

Acquired through skin-to-skin or fomite contact in children and is sexually transmitted in adulthood.

Lesions appear as umbilicated, pearl-like, smooth papules. At least one third of patients will develop symptoms of local erythema, swelling or pruritus.

Diagnosis is usually clinical.

Children are primarily managed conservatively. Adults should be treated with curettage, cryotherapy or cantharidin. However, available treatment options are the same for both adults and children.

Complications relate to treatment; discomfort, secondary infection of the wound or scarring may occur.

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. The histological equivalent of epidermal collections of molluscum bodies is referred to as Henderson-Patterson bodies; virally infected keratinocytes with a central orifice. Lesions are generally caused via skin-to-skin or fomite contact in children and by sexual transmission in adults.[1]Silverberg NB. Warts and molluscum in children. Adv Dermatol. 2004;20:23-73. http://www.ncbi.nlm.nih.gov/pubmed/15544196?tool=bestpractice.com [Figure caption and citation for the preceding image starts]: Extensive molluscum lesions on the flank of a young child; lesions are flesh to pearly coloured with central dellsFrom the collection of Dr Nanette Silverberg [Citation ends].