Molluscum Contagiosum

Question 1

What is the organism responsible for MC?

Answer 1

Molluscum contagiosum virus (MCV)

Question 2

How is it transmitted?

Answer 2

Directly - by close personal contact.

Indirectly - by fomites on contaminated surfaces like shared towels or flannels.

Question 3

How is MC most commonly seen in?

Answer 3

Children aged 1 to 11 years old.

Question 4

Where do lesions commonly appear?

Answer 4

Trunk and flexures but can occur anywhere on the body

(except the palms of the hands and the soles of the feet)

Question 5

What is molluscum contagiosum also known as?

Answer 5

Water warts

Question 6

How would you describe molluscum contagiosum?

Answer 6

• Pinkish or pearly white papules with a central umbilication
• Up to 5 mm in diameter.
• Lesions appear in clusters

Question 7

What self care advise would you give?

Answer 7

• Reassure people that molluscum contagiosum is a self-limiting condition.
• Spontaneous resolution usually occurs within 18 months
• Explain that lesions are contagious, and it is sensible to avoid sharing towels, clothing, and baths with uninfected people (e.g. siblings)
• Encourage people not to scratch the lesions. If it is problematic, consider treatment to alleviate the itch
• Exclusion from school, gym, or swimming is not necessary

Question 8

Answer 8

Question 9

What treatment advise would you give?

Answer 9

• Treatment is not usually recommended
• Squeezing (with fingernails) or piercing (orange stick) lesions may be tried, following a bath. Treatment should be limited to a few lesions at one time
• Cryotherapy may be used in older children or adults, if the healthcare professional is experienced in the procedure
• Eczema or inflammation can develop around lesions prior to resolution. Treatment may be required if:
  
  • Itching is problematic; prescribe an emollient and a mild topical corticosteroid (e.g. hydrocortisone 1%)
  • The skin looks infected (e.g. oedema, crusting); prescribe a topical antibiotic (e.g. fusidic acid 2%)

Question 10

When may you need to refer MC?

Answer 10

• For people who are HIV-positive with extensive lesions urgent referral to a HIV specialist
• For people with eyelid-margin or ocular lesions and associated red eye urgent referral to an ophthalmologist
• Adults with anogenital lesions should be referred to genito-urinary medicine, for screening for other sexually transmitted infections