Educational/Dermatology


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Educational/Dermatology - Molluscum Contagiosum: a skin infection with late diagnosis
MOLLUSCUM CONTAGIOSUM


Molluscum Contagiosum: a skin infection with late diagnosis

What is it

Molluscum Contagiosum is a skin infection caused by a DNA virus belonging to the Pox virus family and transmitted by direct or indirect contact such as sharing towels, bathrobes, gym equipment, etc..

What does it look like

The first lesion is a 2-6 mm diameter plain papule, depressed in the center. Other smaller papules originate from this first lesion nearby. Molluscum Contagiosum does not give symptoms and this is the main reason why the diagnosis is delayed.

 
How to recognize it

The papules are skin-color with shiny appearance and spread rapidly increasing in number. The fact that lesions increase rapidly should be prognostic for an infection.

 
Who gets affected

Children and adults are the two categories of persons affected by Molluscum Contagiosum. In children, Molluscum Contagiosum are distributed mainly on the face, trunk and limbs, less frequently in the genital area; in adults are almost exclusively located in the genital area.

 
Is Molluscum Contagiosum frequent

Molluscum Contagiosum are a common form of skin infection in children and adults; this infection has been rapidly increasing in recent years.

 
How does the infection occur

As the name implies, Molluscum Contagiosum is a highly contagious disease. Among children it is spread by direct contact with playground games, especially in the age of kindergarten. In adults, the primary route of infection is sexual intercourse.

 
The duration of infection

Molluscum Contagiosum usually regress spontaneously once a state of specific immunity is established. Unfortunately they may be present, spread and be contagious to others for two to three years. For this reason treatment and elimination of lesions is recommended.

 
The treatment

The treatment varies depending on the case, child or adult, and the number of lesions.
In children, when Molluscum lesions are 3 to 4, these can be removed by ring-shaped curette. When lesions are more numerous, it is recommended to destroy them by applying acids.
The acid to use is concentrated salicylic acid in elastic collodion. This technique was originally developed to treat the warts that cannot be curetted, such as periungual warts and plantar mosaic warts, but it can also be used to treat treat Molluscum Contagiosum.
The underlying principle is based on the capacity of salicylic acid to pass through the horny layer of the skin and remain in situ for a number of days.
This method uses 30% salicylic acid in elastic collodion.

The procedure is as follows:
• Apply a drop of salicylic acid in collodion. After a few seconds, the collodion dries and forms an adherent white film.
• The salicylic acid will start penetrating and continue to act for about 48 hours.
• One week later, repeat the application of salicylic acid in collodion.
• Continue repeating the procedure every week until the wart has gone.
The method is as effective as curettage and has the advantage that it can be practiced at home; it is also completely painless.
In order to ensure the correct diagnosis of the wart and receive the first application of salicylic acid in collodion, it is advisable to consult a dermatologist.
The formula of salicylic acid in elastic collodion is:
Salicylic acid 3
Elastic collodion 5% 5
Ethyl alcohol 1
Ethyl ether 1
In a TIGE container (with applier)
In adults, it is advisable to proceed directly with the ring-shaped curette because genital area do not tolerate treatments with acids.
Destruction of Molluscum Contagiosum with thermal energy (diathermocoagulation-LASER-liquid nitrogen) it is not recommended because it can leave marks and scars and it is often followed by relapse.

 
The importance of early diagnosis

Molluscum Contagiosum spreads rapidly in tens and hundreds of lesions making therapeutic treatment complex. Early recognition of the first papules as Molluscum Contagiosum is of great importance both for the treatment and for restraint of the infection to others. (see photo gallery)