Description

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.

Epidemiology

Prevalence

• 1% in the United States, occurring mainly in children aged 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

Risk Factors

• Skin-to-skin contact with infected person
• Contact sports
• Swimming
• Atopic dermatitis
• Sexual activity with infected partner
• Immunocompromised: HIV, chemotherapy, corticosteroid therapy, transplant patients, patients on biologics

General Prevention

• 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.
• HIV/AIDS