molluscum%20contagiosum
MOLLUSCUM CONTAGIOSUM
Molluscum contagiosum is an infection due to poxvirus that results into discrete skin lesions with central umbilication.
Spread is by skin-to-skin contact, fomites spread and autoinoculation.
Patients with atopic dermatitis, HIV or immunodeficiency are particularly susceptible.
Incubation period may be from 2-7 weeks.
In children, it usually presents with lesions on the face, scalp, ears, trunk and extremities and crural folds while in adults, it is typically sexually transmitted and affects the groin, genital area, thighs and lower abdomen.

Physical Examination

  • Usually asymptomatic, smooth, flesh-colored, firm round papules w/ central umbilication where cheesy materials can be expressed
  • Large lesions may present as polypoid growths w/ a stalk-like base
  • Lesion size is usually 2-6 mm in diameter
  • Lesions may be grouped together in a small area (often in linear arrangement-pseudo-Kobner) or may become more widely spread
    • 10% of patients develop eczematous dermatitis which resolves as the infection clears
  • May be pruritic & inflammed in the presence of pyogenic infection or in immune-suppressed state
  • Papules may occur anywhere in the body w/ predilection to the face, neck, axilla, cubital creases, thighs & genitoanal region but the palms & soles spared
  • Conjunctivitis & corneal lesions may be part of the complications

Laboratory Tests

Laboratory Findings

  • Fluorescent antibody technique identifies MCV antigen
Histological Exam
  • May be used if clinical presentation is not diagnostic
  • Central core of lesion can be expressed, smeared & stained on a slide to demonstrate brick-like inclusion bodies
  • Skin punch biopsy findings of eosinophilic viral inclusion bodies (molluscum bodies/Henderson-Paterson bodies) on the stratum corneum
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