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Molluscum contagiosum is a common, benign, viral (poxvirus) skin infection, characterized by small (2 to 5 mm), waxy white or flesh-colored, dome-shaped papules often with central umbilication. Lesions contain a cheesy grayish white material. Molluscum contagiosum is highly contagious and spreads by autoinoculation, skin-to-skin contact, sexual contact, and shared clothing/towels. Molluscum contagiosum is a self-limited infection in immunocompetent patients but can be difficult to treat and disfiguring in immunocompromised patients.
- 1% in the United States, occurring mainly in children 2 to 15 years and sexually active young adults
- 5–18% HIV population
Etiology and Pathophysiology
- DNA virus; Poxviridae family
- Four genetic virus types, clinically indistinguishable
- Virions invade and replicate in cytoplasm of epithelial cells causing abnormal cell proliferation.
- Genome encodes proteins to evade host immune system.
- Incubation period: 2 to 6 weeks
- Time to resolution: 6 to 24 months
- Not associated with malignancy
- No cross-hybridization or reactivation by other poxviruses
- Skin-to-skin contact with infected person
- Contact sports
- Eczema, atopic dermatitis
- Sexual activity with infected partner
- Immunocompromised: HIV, chemotherapy, corticosteroid therapy, transplant patients
- Avoid skin-to-skin contact with host (e.g., contact sports, sexual activity).
- Avoid sharing clothing and towels.
Commonly Associated Conditions
- Atopic dermatitis
- Immunosuppression medications: corticosteroids, biologics, chemotherapy, etc.