Molluscum contagiosum

Aetiology

Poxvirus family in a specific genus, the molluscipox

specific to humans

most commonly causing disease in childhoodThe age of peak incidence is reported as

between 2 and 5 years The disease is rare under the age of 1 year,

perhaps due to maternally transmitted immunity and a long incubation period

Infection follows contact with infected persons or

contaminated objects,

antiapoptotic protein

The incubation period is variouslyestimated at 14 days to 6 months. The individual lesion is a shiny, pearly white,

hemispherical, umbilicated papule which may show

a central pore. It may be identifi ed with a hand lens or dermatoscopewhen less than 1 mm in diameter.

Enlarging slowly---- >3cm giant

most cases are self-limiting within 6–9months, it is not unusual for some to persist for

3 or 4 years Individual lesions are unlikely to persist for

more than 2 months

sites

The distinctive UmbilicationThe diagnosis can be confirmed by direct

microscopyor electron microscopy of the papule contents,

by histopathology or by molecular analysis

therapy is not necessary and natural resolution can be awaited.

The risk of dissemination of the infection can be minimized by reducing scratching, which can both damage adjacent skin and spread virus from mature papules

Treatments aim to destroy the infected epidermal cells, stimulate an immunological response or act directly against the virus.

Surgical removal of molluscum contagiosum by curettage

Cryotherapy is effective and commonly used in older children and adults, but needs to be repeated at 3–4 weekly intervals.

Topical salicylic acid preparations , tretinoin adapalene , nitric oxide cream and potassium

hydroxide solution all lead to an irritant reaction but if the strength of preparation and the frequency of application are adjusted, individuals can tolerate repeated treatments until resolution occurs

Imiquimod cidofovir