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About molluscum contagiosum
Molluscum contagiosum is a common skin condition caused by a poxvirus. 4 It is characterised by small, discrete, waxy, skin-coloured dome-shaped papules, 3-5mm in diameter. 1 It is transmitted through direct contact with an infected person or an object (such as a shared towel). When the lesions are squeezed or traumatised, a creamy, grey-white material can be extruded. In immunocompetent people there are usually fewer than 20 papules. 1
The condition is common in children and generally presents with asymptomatic papules, although they can sometimes present with itching, redness and occasionally bacterial superinfection with inflammation and pain. 4 The incidence has been estimated as 15-17/1,000 children aged 1-4 years in the UK, with girls and boys similarly affected. 4 The overall reported prevalence in children is 5-12%. 4 Infection is associated with a recent history of swimming 4 and there may be an association with atopic dermatitis, possibly due to an impaired skin barrier. 1 In adults it can be sexually transmitted and affect the genitalia. Infection generally lasts between 2 weeks and 2 years (median 8 months) 1 and generally resolves without scarring. Molluscum contagiosum can cause considerable anxiety among parents. 4 A validated diagnostic tool is available that aims to help parents diagnose and understand the condition. 5
Treatment options
National guidance recommends giving reassurance that molluscum contagiosum is a self-limiting condition that usually resolves spontaneously within 18 months, together with advice to avoid sharing towels, clothing and baths, and to avoid scratching the lesions. Exclusion from school, gym or swimming is not necessary. 2
Treatment, if used, is intended to accelerate resolution through destruction of the lesions to induce an inflammatory response. 6 Possible reasons to treat molluscum contagiosum include: alleviation of discomfort including itching; for cosmetic reasons; because of social stigma associated with many lesions; limiting spread to other areas of the body or other people; and to prevent scarring, secondary infection, trauma and bleeding of lesions. 6
Physical destruction
Treatment includes simple trauma after a bath by gentle squeezing (with fingernails while wearing gloves and discarding the curd-like material inside), or pricking with a sterile needle; lesions take 1-2 weeks to improve. 2 Cryotherapy may be used in older children or adults, by a healthcare professional...