Molluscum contagiosum Molluscum contagiosum is a viral skin disease caused by the Molluscum contagiosum virus (MCV), a member of the Poxviridae family. The infection manifests as characteristic dome-shaped papules with a central pit.
The disease is most often benign and tends to resolve spontaneously, but can persist for several months and cause significant cosmetic discomfort.
Pathogenesis of molluscum contagiosum
The virus penetrates through microtraumas in the skin and replicates in the epidermis. It causes keratinocyte hyperplasia with the formation of intracellular inclusions (Henderson-Patterson bodies).
Important: virus does not penetrate into the systemic bloodstream and remains localized in the skin.
Epidemiology
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Children aged 1–10 years are most often affected.
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Prevalence among children can reach 5–10%, in some populations it is higher
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In adults, it is more common in:
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immunosuppression
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HIV infections
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atopic dermatitis
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sexual intercourse (localization in the anogenital area)
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Seasonality is moderately expressed and is not a strictly proven factor.
Genetic predisposition
To date There is no convincing evidence of a clear genetic predisposition to molluscum contagiosum..
Studies on the role of cytokines (IL-6, TNF) and immune mechanisms are being conducted, but a reliable link between specific mutations and the disease has not been established.
Risk factors
| Factor | Mechanism |
|---|---|
| Skin-to-skin contact | The main route of transmission |
| Atopic dermatitis | Skin barrier dysfunction |
| Immunosuppression | Reduced control of viral replication |
| Microtraumas of the skin | Facilitate virus penetration |
| Sexual intercourse | Anogenital form |
Clinical picture of molluscum contagiosum
Typical signs:
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Dome-shaped papules 2–5 mm
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Mother-of-pearl color
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Central depression
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Painlessness
When pressed, a whitish substance may be released.
Possible complications:
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Secondary bacterial infection
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Inflammatory reaction around the elements
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Post-inflammatory hyperpigmentation
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Rarely - scarring
Diagnostics
The diagnosis is clinical.
Additional methods are used in case of atypical presentation:
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Dermatoscopy
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Histology (rare)
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PCR (for complex differential diagnostics)
Differential diagnosis:
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Viral warts
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Keratoacanthoma
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Milia
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Basal cell carcinoma (in atypical forms in adults)
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Chicken pox
Treatment of molluscum contagiosum
Important: The disease often goes away on its own within 6–12 months.
Treatment approaches
| Method | Advantages | Flaws |
|---|---|---|
| Observation | No trauma | Long-term course |
| Curettage | Quick removal | Pain syndrome |
| Cryotherapy | Efficiency | Pigmentation is possible |
| Imiquimod | Immunomodulation | Skin irritation |
| Podophyllotoxin | Suitable for adults | Restrictions in children |
Current recommendations
International recommendations (NICE, CDC) allow for a watchful waiting approach in the absence of complications.
Brief clinical algorithm for patient management
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Clinical examination
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Exclusion of differential diagnoses
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Assessment of immune status
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Determining the need for treatment
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Selecting a removal method
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Control after 4-8 weeks
When to see a doctor urgently
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Rapid increase in the number of elements
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Severe inflammation
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Signs of a bacterial infection
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Localization in the eye area
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Immunodeficiency
Classification
ICD-10:
B08.1 - Molluscum contagiosum
ICD-11:
1E76.Y - Molluscum contagiosum
Age-related features
Children
Often multiple elements, especially in atopic dermatitis.
Adults
Most often, the localization is anogenital.
Immunocompromised patients
Large, recurring forms may be observed.
Prevention
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Avoid close contact with affected areas.
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Do not share towels.
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Treatment of skin microtraumas
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Control of atopic dermatitis
Dr. Korzhikov advises
With the typical clinical picture of molluscum contagiosum in children, a watchful waiting approach is most often advisable. Aggressive removal of all lesions can lead to scarring and psycho-emotional stress.
In adults with anogenital localization, it is necessary to exclude concomitant sexually transmitted infections and assess the immune status.
In case of atypical course or relapses, it is advisable to consult a dermatologist and exclude immunodeficiency conditions.
FAQ
Is molluscum contagiosum contagious?
Yes, it is transmitted by skin-to-skin contact.
Is it possible to extrude elements?
Not recommended due to risk of infection.
Are there any scars?
Rarely, more often due to trauma.
Should all children be treated?
Not always - in the absence of complications, observation is acceptable.
