MOLLUSCA CONTAGIOSA

Molluscum contagiosum is extremely common in children of preschool-age and elementary school-age.

μολυσματικη τερμινθος

The scarcity in adults, even parents with very close contact with their infected children, suggests nearly universal exposure and long-lasting immunity to the virus.

Discrete, dome-shaped, flesh-coloured to erythematous papules, frequently with a central umbilication, are characteristic. They may look like pustules on casual examination but are solid to palpation. They may be located anywhere but are common in the axillae, sides of the trunk, abdomen, face, thighs, and buttocks. They may appear like skin tags in intertriginous areas. Secondary infection or a host inflammatory response to the virus may result in large, erythematous, painful papules or pustules. Surrounding dermatitis is very common and may be difficult to treat until the lesions are gone. Lesions around the eye may cause conjunctivitis.

Clinical diagnosis is usually very easy, although finding mollusca within a sea of keratosis pilaris may be challenging. Folliculitis, skin tags, warts, and milia can usually be excluded on clinical grounds. Dermatitis may dominate the clinical picture and the individual mollusca may be hidden within the scaling erythema of atopic dermatitis. Very large mollusca may look like epidermoid cysts. A KOH smear of a molluscum examined microscopically is diagnostic but requires some experience and is seldom necessary. Biopsy is rarely needed and the pathologic diagnosis of mollusca is usually a surprise finding when some other entity was suspected.

Mollusca contagiosa are caused by a DNA poxvirus. Infection is usually spread via person-to-person contact but may spread via fomites.

About the author:

Christofer Tzermias

Specialised in the UK (Oxford & London) and in North America (New York & San Diego) in the field of LASER Dermatology, Dr Tzermias, has been providing dermatological state-of-the-art treatments using cutting-edge LASER and Energy based Devices for over 20 years. He has been Director of Interventional and LASER Dermatology Department at the Athens Medical Center for over 18 years and for the last 9 years is the Scientific Director of IQ - Intensive Quality Dermatology & Cosmetic Surgery Clinics, which at the 2017 Healthcare Awards won the ‘Innovation Award for Innovative Services’ for their pioneering contributions. Since 2018, IQ Dermatology & Cosmetic Surgery Clinics has also been operating in London, UK and in Muscat, Oman. Dr Tzermias is a Fellow of the world-renowned American Society for LASER Medicine and Surgery (ASLMS), a Founder Member of the European Society LASER Dermatology (ESLD), the Vice President of the ‘Open Health Alliance’ and he is also on the Board of Directors of Elitour - Greek Medical Tourism Council.

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