Molluscum contagiosum

Question 1

What is molluscum infection?

Answer 1

Benign epidermal eruption of the skin due to molluscum contagiosum

Question 2

What type of organism is molluscum contagiosum?

Answer 2

LARGE
DNA virus
belongs to Poxviridae family
Molluscopix genus

Question 3

How subtypes of molluscum contagiosum are there?

Answer 3

4

Question 4

What is the commonest subtype of molluscum contagiosum virus (MCV)?

Answer 4

MCV-1

Question 5

Is there any clinical difference between the different MCV subtypes?

Answer 5

No

Question 6

Which MCV subtype appears relatively common in immunocompromised and HIV infection?

Answer 6

MCV-2

Question 7

How many MCV subtypes does an individual infection usually have?

Answer 7

ONE

Question 8

Who typically get molluscum?

Answer 8

Children

Question 9

What proportion of molluscum infection presents in children?

Answer 9

90%

Question 10

How is MCV infection acquired?

Answer 10

Routine physical contact

Contact with fomites

Question 11

Where do molluscum typically occur if infection is sexually acquired?

Answer 11

genitals
buttocks
pubic region
lower abdomen
upper thighs

Question 12

Molluscum lesions - describe what they look like?

Answer 12

Smooth-surfaced
Firm
Dome-shaped papules
Central umbilication
Pearly white, pink or yellow

Question 13

How many molluscum are typical?

Answer 13

1-30 in CLUSTERS

Question 14

What can happen to the skin from which the molluscum appear?

Answer 14

Koebner phenomenon (inflammatory dermatitis)

Question 15

What proportion of PLWHIV got molluscum pre-ART?

Answer 15

5-18%

Question 16

Where does molluscum typically occur in PLWHIV?

Answer 16

Face and neck

Eyelids

Question 17

When might the first molluscum appear in HIV infection?

Answer 17

as part of IRIS following starting ARVs

Question 18

When might dermatoscopy be indicated for molluscum diagnosis?

Answer 18

When clinical diagnosis is challenging

Question 19

How is molluscum diagnosed?

Answer 19

Clinical based on characteristic appearance

Question 20

What are the potential differentials to molluscum?

Answer 20

BCC
cysts/abscesses
keratocanthoma
cutaneous horn
genital warts
ectopic sebaceous glands
vulvar lymphangioma circumscription
Disseminated fungal infection in immunosuppression

Question 21

What increases the risk of autoinoculation with molluscum?

Answer 21

Waxing/shaving

Squeezing/picking molluscum as central plug very infectious and can be spread to uninfected skin

Question 22

How else might molluscum spread other than direct contact?

Answer 22

Towels, bed linen, clothes

Swimming pool

Question 23

What is the preferred treatment for molluscum?

Answer 23

No treatment in immunocompetent

Question 24

What are the disadvantages of topical treatment for molluscum?

Answer 24

Local skin reaction
Potential scar formation
Limited evidence of efficacy

Question 25

Why might a person opt for treatment of molluscum?

Answer 25

cosmetic reasons
stigma
symptoms (pruritus, secondary infection)
concerns regarding transmis- sion and autoinoculation

Question 26

What topical treatments can be considered for treatment of molluscum?

Answer 26

Podophylotoxin
Imiquimod
Cryotherapy

Question 27

Which topical therapies should be AVOIDED in pregnancy?

Answer 27

Podophylotoxin

Imiquimod