Molloscum

Molloscum is a benign skin disease that is quite common in the US. Read and know all about the causes, symptoms, diagnosis and treatment of this disorder.

What is Molloscum?

It is the abbreviated term for Molloscum Contagiosum. It is a skin rash characterized by the development of round, elevated bumps on the skin surface.

Picture 1 – Molloscum Contagiosum

The condition is often simply referred to as MC.

Molloscum ICD9 Code

The ICD9 Code for Molloscum is 078.0.

Molloscum Incidence

This is a common worldwide disease and accounts for 1% of all skin conditions in the United States. It mainly affects boys more than girls. It is primarily visible in children and young adults. Unfortunately, the prevalence of this skin condition is on a rise.

Molloscum Symptoms

The condition typically gives rise to discomforting papules on the skin surface. These are initially small and painless. In the later stages, these usually turn into nodules having a fleshy, pearly appearance. The nodules often have a slight depression or dimple in the middle. The nodules may arise in a line in skin regions that have been scratched by the patient. Skin irritation, caused by scratching or any other similar activity, can make the virus spread in a line or in clusters. When arising in groups, these viral papules are referred to as “crops”.

The papules vary from 2-5 mms in width. The lesions commonly arise on various regions of the body, such as

• Face
• Neck
• Armpit
• Arms
• Hands

In adults, these may develop on the abdomen, genitals and the inner thigh. The papules may arise on any region of the human body, excluding the palms and the soles. Generally, there is no swelling or subsequent redness in the hickeys until they are scratched or digged.

What causes Molloscum?

The condition results from a viral infection. It usually arises due to a virus that belongs to the Poxvirus family. The infection can be contracted in a number of ways, like:

Direct contact

A healthy child can contract the infection if he comes in direct contact with a Molloscum papule.

Indirect contact

The infection can also arise through contact of the skin with contaminated objects, such as clothes, toys and towels.

Sexual contact

The virus can spread during sexual contact and give rise to lesions on the genitalia. Initially, Molloscum papules on the genital may be confused for warts or herpes lesions. Unlike herpes, however, the lesions can be painless.

Having a weakened immunity can also make a person susceptible to this condition. Patients of AIDS can suffer from a rapidly deteriorating case of Molloscum Contagiosum due to a severely weakened immune system.

Is Molloscum Contagious?

The condition is caused by viral infection. Naturally, it spreads from person to person and is contagious in nature. However, it remains as long as the bumps persist on the skin surface. Direct contact with these lesions or indirect contact with objects contaminated by these papules can give rise to the condition.

Molloscum Diagnosis

The diagnosis of these lesions is based on their physical appearance. In most cases, medical tests are not required. If diagnosis becomes confusing, a slide examination of the core of a lesion can be used for diagnosis. Although the virus cannot be cultured in routine procedures, an excisional biopsy can help confirm its presence.

Molloscum Differential Diagnosis

This skin disease resembles warts, infections, skin cancers and many other skin conditions. The differential diagnosis of Molloscum aims at distinguishing it from disorders like:

• Acquired reactive perforating dermatosis of renal failure
• Cutaneous aspergillosis
• Cutaneous cryptococcus
• Cutaneous coccidioidomycosis
• Cutaneous histoplasmosis
• Eccrine poroma
• Epidermal cyst
• Flat warts (verruca plana)
• Foreign body granuloma
• Keratoacanthoma
• Kyrle disease
• Lichen planus
• Pyoderma
• Perforating serpiginous elastoma
• Perforating folliculitis
• Perforating granuloma annulare
• Verruca vulgaris (warts)
• Verrucous perforating collagenoma

Molloscum Treatment

It is not always compulsory to seek treatment for this condition. In people with normal immune system, the papules often go away naturally within a few months to a few years. Unless infected by bacteria, these heal without leaving scars on the skin. However, people with a compromised immune system (due to underlying conditions such as AIDS) can suffer from a rapidly deteriorating case of MC. Treatment is absolutely necessary in such cases.

Treatment options for these skin papules can be non-invasive as well as invasive.

Non-invasive Treatment

The lesions can be effectively removed with medications that are used to remove warts. However, these can lead to the formation of blisters that may result in temporary discoloration of the skin. Imiquimod or Tretinoin cream may be prescribed for cure. Cantharidin, commonly known as “beetle juice,” is the most commonly used solution for treating the lesions.

Invasive Treatment

Invasive cure includes surgical removal of individual lesions through needle electrosurgery or by freezing and de-coring scraping. The most popular surgical treatments involve removal using heat (called cautery), removal by freezing using liquid nitrogen (known as Cryotherapy) or by scraping of the lesions (known as Curettage). However, surgical removal of the individual lesions may lead to formation of scars in the operated spots.

Molluscum Home Remedy

In some cases, natural home remedies are seen to be quite effective in curing these skin papules. These include:

Sea Salt Scrub

Make a homemade solution by combining 2 cups of sea salt with 1/2 cup of olive oil, 1/4 cup of grape seed oil, 2 drops of essential tea tree oil and 1 tablespoon of honey. Store this in a glass jar to last for several months. As you shower, massage this scrub gently into the papules. Let the mixture settle into the skin for 1-2 minutes. Rinse this off with clear water. Use a clean towel to pat the skin dry.

Duct Tape

This is a common home remedy for skin bumps and warts. Cut a very small strip of duct tape and paste it at night over the skin region with bumps. Leave the tape for a few hours and remove it in the morning. After a few days, you will find the bump has resolved. Duct tape slowly removes dead skin from the wart and eradicates the wart virus residing in the skin.

Molloscum Complications

The complications of this disorder mainly include:

• Persistence of lesions
• Spread of lesions
• Recurrence of lesions
• Secondary bacterial skin infections
• Scarring (in case of excessive scratching or surgery)

In some cases, the papules can become red and swollen and give rise to a condition known as Molluscum Dermatitis. This is supposed to arise due to an immune response to the infection. In some patients, conjunctivitis can develop if the lesions arise on the eyelids.

Molloscum Prognosis

The condition has an excellent prognosis. The disease is self-limited in most cases. In some cases, however, individual lesions may remain for 6-18 months before disappearing. This usually occurs in people with a suppressed immune system. In healthy people, individual lesions generally go away in about 2 – 3 months.

Molloscum in Children

Molloscum is a common skin problem in children and mainly affects boys. A child can contract it through direct contact with other children. He or she may also get it by touching the toys, towels or clothes that have come in contact with the infected skin area of other kids suffering from the condition. The disease leads to tiny, hard bumps on the skin that can become red, white, pink or flesh-colored in appearance. The bumps mainly arise on the skin over the face, neck, arms, armpits, hands and over the waist. These can be treated by medicated creams, Cryotherapy, Curettage and Laser treatment.

The condition can be prevented by inculcating good hygiene into your children and teaching them to wash hands frequently with soap and water. They should also be taught not to share towels, clothes or other personal items with their friends.

Molloscum Prevention

The condition can be prevented by:

• Avoiding direct contact with the papules
• Not sharing towels or other objects with other individuals
• Following good hygiene, such as washing hands frequently
• Swimming in pools with chlorinated water

You can also prevent the condition by avoiding sex. Abstinence from physical intimacy can help you prevent molluscum virus as well as other sexually transmitted disorders (STD). You may also avoid this viral infection by having sexual relationship with an uninfected partner. Although condoms cannot offer full protection, they can decrease the chances of getting STDs or spreading them. Naturally, it is recommended for you to use condoms every time you have sex with a new partner.

Molloscum Contagiosum Pictures

Check out these Molloscum images to know how these skin bumps look like. These Molloscum photos will help you get an exact idea about the type of papules caused by this condition.

Picture 2 – Molloscum Image

Picture 3 - Molloscum Contagiosum Photo

If you suspect yourself to be having symptoms of molluscum infection, get in touch with your health care provider. Medical treatment is particularly recommended if you suffer from new symptoms or if your lesions spread or persist. Timely treatment can help you recover from the condition much faster and go about your daily work without nagging health issues.

References:

http://emedicine.medscape.com/article/910570-overview

http://www.emedicinehealth.com/molluscum_contagiosum/article_em.htm

http://www.webmd.com/skin-problems-and-treatments/tc/molluscum-contagiosum-topic-overview

http://www.mayoclinic.com/health/molluscum-contagiosum/DS00672

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001829/