Molluscum Contagiosum

  • Molluscum contagiosum is a rare viral infection that is exclusive to humans. It is characterised with {the} presence of small elevated lesions called papules. These papules have a waxy surface and are seen on various parts {the} body such as {the} face, trunk, arms and legs. It can also affect {the} armpits but does not involve {the} palms. It has also been found to affect {the} eyelids.
  • In this article, we shall discuss molluscum contagiosum in a bit more detail.

    Cause of molluscum contagiosum

    Molluscum contagiosum is caused by a viral infection. The portal of entry of {the} riders into {the} body is usually through some form of break in {the} skin. This occurs through direct skin to skin contact as well and can therefore be seen in individuals who share showers or athletes who share equipment in {the} gym.

     

    Having low levels of immunity such as in {the} case of HIV virus infections can also make an individual prone to developing molluscum contagiosum. In such individuals, {the} lesions are a lot more widespread. In children, {the} condition occurs due to sharing of towels and sponges. Studies have also shown {the} development of molluscum contagiosum affecting {the} eyelids of both eyes following treatment of rheumatoid arthritis with specialist drugs such as methotrexate. Case studies have reported {the} eyelids being affected in children.

    Clinical features of molluscum contagiosum

    Typically, molluscum contagiosum results in {the} formation of multiple small papules with a waxy surface. They might be clearly evident on {the} body especially on {the} eyelids. Typically, scratching {the} lesions can make them worse as more and more lesions form along {the} line of scratching. This is a typical phenomenon called as Koebner phenomenon

    .Molluscum Contagiosum

    Upon examination, {the} lesions are flesh coloured and vary between 2 to 5 mm in size. Patients with poor immune levels tend to have multiple lesions all over {the} body. The involvement of {the} eyelids and {the} face is commonly seen in children whereas {the} involvement of {the} groin area is seen in adults. Associated with molluscum contagiosum are other skin conditions such as atopic dermatitis and eczema.

    Diagnosis of molluscum contagiosum

    A diagnosis of molluscum contagiosum can be made by tests such as polymerase chain reaction and biopsy. A biopsy demonstrates {the} presence of specific structures within {the} lesions called inclusion bodies. These bodies can be stained using specific stains to help identify them under a microscope.

    Treatment of molluscum contagiosum

    Most cases of molluscum contagiosum tend to resolve themselves in a few months. Molluscum contagiosum that affect {the} eyelids might be managed conservatively without performing any intervention. However may be, a small amount of trauma to {the} lesion can help get rid of it. Another form of treatment is called curettage and involves administration of an anaesthetic agent followed by removal of {the} lesion completely.

    Medical treatment is also available to manage molluscum contagiosum. However, detailed studies have shown that there does not appear to be any additional benefit of using these treatments (skin creams, anti-viral agents and herbal medicines) when compared to not offering {the} patient any treatment whatsoever.

    Following {the} treatment, patients might require follow-up appointments to see if {the} lesion is recurring.

    Conclusion

    Molluscum contagiosum is an uncommon problem that can affect various parts of {the} body. The involvement of {the} eyelids is more often seen in children and usually resolves by itself. Specific treatments can be offered though recurrence rates can be high.

 

Molluscum contagiosum (MC) is a viral infection of {the} skin or occasionally of {the} mucous membranes. It is caused by a DNA poxvirus called {the} molluscum contagiosum virus (MCV). MCV has no animal reservoir, infecting only humans. There are four types of MCV, MCV-1 to -4; MCV-1 is {the} most prevalent and MCV-2 is seen usually in adults and often sexually transmitted. This common viral disease has a higher incidence in children, sexually active adults, and those who are immunodeficient, and {the} infection is most common in children aged one to ten years old.MC can affect any area of {the} skin but is most common on {the} trunk of {the} body, arms, and legs. It is spread through direct contact or shared items such as clothing or towels.

The virus commonly spreads through skin-to-skin contact. This includes sexual contact or touching or scratching {the} bumps and then touching {the} skin. Handling objects that have {the} virus on them (fomites), such as a towel, can also result in infection. The virus can spread from one part of {the} body to another or to other people. The virus can be spread among children at day care or at school. Molluscum contagiosum is contagious until {the} bumps are gone-which, if untreated, might be up to 6 months or longer.

The time from infection to {the} appearance of lesions can range up to 6 months, with an average incubation period between 2 and 7 weeks.

Molluscum Contagiosum

 

Diagnosis is made on {the} clinical appearance; {the} virus cannot routinely be cultured. The diagnosis can be confirmed by excisional biopsy.

Histologically, molluscum contagiosum is characterized by molluscum bodies in {the} epidermis above {the} stratum basale, which consist of large cells with:

  • abundant granular eosinophilic cytoplasm (accumulated virons), and
  • Symptoms

Molluscum contagiosum lesions are flesh-colored, dome-shaped, and pearly in appearance. They are often 1–5 millimeters in diameter, with a dimpled center. They are generally not painful, but they might itch or become irritated. Picking or scratching {the} bumps might lead to further infection or scarring. In about 10% of {the} cases, eczema develops around {the} lesions. They might occasionally be complicated by secondary bacterial infections. In some cases {the} dimpled section might bleed once or twice. The viral infection is limited to a localized area on {the} topmost layer of {the} epidermis. Once {the} virus containing head of {the} lesion has been destroyed, {the} infection is gone. The central waxy core contains {the} virus. In a process called autoinoculation, {the} virus might spread to neighboring skin areas. Children are particularly susceptible to auto-inoculation, and might have widespread clusters of lesions.

 
Procedures
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