Molluscum contagiosum

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Viral skin infection. It gets better

Common in children. It presents with a few, several or occasionally many small umbilicated skin lesions. They spread if picked and the skin scratched elsewhere, and in common with other viral skin infections are more widespread in children with eczema.

Contents

Aetiology

A pox virus.

Treatment

It is generally agreed that doing nothing is significantly superior to any treatment.[1] [2]

If the doctor is incapable of this or feels obliged to recommend the parent doing something, attempts to minimise harm and suffering are in order. The lesions may take 1-2 years to clear and parental pressure/blackmail "Can it not be done privately?" or "My wife/grannie says something must be done" is not unknown.

Many treatments have been proposed and presumably applied. The presence of actual evidence of effectiveness for one of them would presumably dismiss all others from consideration. Sometimes the question "Who are we treating here?" can be helpful.

Interventions which have been applied

If eczema is present, treat the eczema.

Exceptions

In the presence of immunosupression, the indication for treatment may be present. The problem of treatments being of minimal efficacy remains.

Histology

Medium power view of molluscum bodies.
Skin biopsy usually not required as easily recognisable clinically. When present, the epithelium contains molluscum bodies. These are large, eosinophilic cytoplasmic inclusions that displace the nuclei.


References

  1. Lio P. Warts, molluscum and things that go bump on the skin: a practical guide. Archives of disease in childhood. Education and practice edition. 2007 Aug; 92(4):ep119-24.(Link to article – subscription may be required.)
  2. Interventions for cutaneous molluscum contagiosum. van der Wouden JC, Menke J, Gajadin S, Koning S, Tasche MJ, van Suijlekom-Smit LW, Berger MY, Butler CC Cochrane Database Syst Rev. 2006; : CD004767


This article is a work in progress. Please feel free to contribute to it.

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