Molluscum contagiosum or contagious molluscum is a viral infection of the skin or mucous membranes. It is often called "water warts". It belongs to the group of sexually transmitted diseases. And although this is not a classic STD disease, sexual transmission is one of the most common.
The causative agent is a DNA poxvirus called molluscum contagiosum virus (MCV). It can only infect people. There are four types of MCV:
- MCV-1;
- MCV-2;
- MCV-3;
- MCV-4.
MCV-1 is the most common, while MCV-2 is more common in adults.
Molluscum contagiosum in children
Molluscum contagiosum is more common in children than in adults. Children up to one year old practically do not get sick with molluscum contagiosum. This is due to the fact that in the first year of life the child’s circle of contacts is small: the child moves in a limited space, often specially prepared for him and under the strict supervision of adults, without trying to come into contact with other children. But as soon as a child begins to actively communicate and independently explore the world, the threat of becoming infected with molluscum contagiosum increases sharply.
The peak incidence of molluscum contagiosum in children occurs between the ages of 2 and 6 years. Immunity at this age is still weak. Children become infected through toys or dirty hands. The virus penetrates the skin in the place where the integrity of the skin is damaged - through wounds, abrasions, cracks. Children's skin is delicate and sensitive, and the activity of a preschool child is great. As a result, numerous microtraumas occur, opening the way for infection. Cases of infection with molluscum contagiosum while swimming in the pool have also been described.
From 6 to 10 years, the incidence of molluscum contagiosum decreases. Instilling household hygiene skills is of great importance. The sooner your child starts taking care of clean hands, the better.
Methods of infection and provoking factors
Infection with the virus occurs through contact with a patient or carrier of the virus. Using things and objects shared with the patient also poses a danger, since orthopoxviruses remain active for some time on various surfaces. For this reason, children often become infected when visiting sports sections, where the likelihood of infection spreading is especially high due to the large crowd of people who use the same sports equipment. Contact sports (such as combat sports) also pose a risk because close contact increases the likelihood of transmitting the virus.
Children's judo section. Photo: nomadsoul1 / freepik.com
In young people who are sexually active, infection most often occurs through sexual contact. As in young children, in older people the provoking factor for infection is weakened immunity. HIV-infected people, as well as people suffering from atopic dermatitis, are at risk. One of the factors in the development of the disease is long-term use of glucocorticoid drugs and cytostatic agents that reduce the activity of the human immune system.
Important! If molluscum contagiosum is sexually transmitted, many people mistakenly believe that they can protect themselves from the virus by using a condom. This is a big misconception, since a condom is only effective in protecting against infections concentrated directly in the urethra, penis, semen or vagina. It is impossible to completely protect yourself from sexually transmitted infections such as molluscum contagiosum, syphilis or genital herpes using a condom.
Symptoms of molluscum contagiosum
The incubation period of the disease ranges from two weeks to several months, but most often the rash appears on the 14-15th day.
At first, single rashes appear, then there are more of them. Molluscum contagiosum can affect any area of the skin except the palms and soles. In children, exposed areas of the arms and legs, as well as the face and neck are most often affected. In adults, the genital area and the inner thighs are most often affected.
In the typical form of the disease, the rashes are located only in one anatomical area; in the generalized form, they spread throughout the body.
Rash
The elements of the rash look like protrusions (papules), firm and painless to the touch, pink or flesh-colored, with a pearlescent top. In the center of the papule there is a small depression, from which, when pressed, a white pasty mass is squeezed out. Papules have a round or oval shape, the size usually varies in the range of 2-5 mm, but sometimes the nodules merge, and then such formations can reach a diameter of 1 cm or more.
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Itching
In some cases, the rash is accompanied by itching, which intensifies when scratching. Under no circumstances should papules be scratched, as this can lead to a bacterial infection. The presence of a bacterial infection is indicated by redness of the skin around the papules, swelling, and suppuration.
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Molluscum contagiosum: what is it and how to get rid of it?
Molluscum contagiosum is a fairly common viral skin infection. What does the mollusk that settles on our body have to do with the inhabitants of water bodies and land? What causes molluscum contagiosum? By what symptoms you can recognize it and how to cure it, we find out from the cosmetologist at the Expert Clinic Kursk, Ekaterina Aleksandrovna Krivdina.
— Ekaterina Alexandrovna, what is molluscum contagiosum? Is he dangerous?
— This is a viral disease in which crater-shaped nodules appear on the affected area of the skin. If you press on them, a cheesy mass comes out. Molluscum contagiosum is not dangerous to human health and is not classified as a tumor. There is also no inflammatory process in the areas where nodules grow.
— What does this disease have in common with invertebrates? Where does this name come from?
— Despite the name, the disease has nothing to do with animals of the mollusc class. The disease received this name due to the external similarity (when viewed under a microscope) of the contents of the nodules with the shape of mollusks. The causative agent of the infection is the large filterable virus Molitor hominis, related to smallpox viruses.
— How can you become infected with molluscum contagiosum? Who is at risk?
— Most often, the virus is transmitted through household contact. Due to the high concentration of the pathogen, for example, in sandboxes on playgrounds, outbreaks of the disease were observed in children's groups.
Infection with molluscum contagiosum in adults occurs through contact, household or sexual contact.
People with reduced immunity are most at risk of infection. These are patients with HIV infection, cancer, allergies, rheumatoid arthritis, and taking glucocorticoids. In addition, the risk of infection is high among medical workers, massage therapists, bathhouse employees, etc. That is, among those who come into contact with the skin of a large number of people.
— How does the infection manifest itself?
— The main symptom of molluscum contagiosum is the formation of nodules on the skin measuring 0.1 to 0.2 cm. They are painless, but are sometimes accompanied by mild itching. The rash can be located on any part of the skin except the palms and soles.
The formations have a dimple in the middle (umbilical depression). At first these are dense, flesh-colored dome-shaped nodules. After some time, they become softer and reach a size of 0.5–0.7 cm. When pressed, a white, mushy mass is released from them. The number of rash elements can be from 5 to several dozen.
— To make a diagnosis of molluscum contagiosum, do you need to conduct any research or is an external examination sufficient?
— As a rule, a visual inspection is sufficient. But in some situations (with an atypical clinical picture), microscopic and (or) pathomorphological analysis of skin biopsies is required.
— How to get rid of molluscum contagiosum? What treatment methods are there?
— According to the recommendations of the Ministry of Health of the Russian Federation, treatment of molluscum contagiosum is carried out by destruction (destruction) of its elements.
To remove molluscum contagiosum, for example, methods such as:
- removal of each element with a curette (a surgical spoon used to scrape off particles of pathological soft tissue);
- removal of rashes using liquid nitrogen (cryodestruction);
- evisceration (husking). The manipulation is performed with special tweezers and is used to eliminate newly appeared rashes. The obtained material can be used for further pathohistological verification of the diagnosis;
- laser therapy;
- electrocoagulation (a procedure during which soft tissue is cauterized in the desired location using an electric current).
— What should a person who has discovered signs of the disease do? Is it possible to remove molluscum contagiosum yourself?
— You need to see a dermatologist as soon as possible. The sooner treatment is started, the faster it will be possible to get rid of the disease and avoid complications in the form of the spread of foci of infection throughout the body. It is not recommended to remove the formation yourself. The fact is that the virus that causes this pathology is very contagious, and elements of molluscum contagiosum must be removed extremely carefully, under special conditions.
— What is the prognosis for treatment? Can a person become infected with molluscum contagiosum again?
— The prognosis for this disease is favorable, but given the potential danger of autoinoculation (spread of infection to other parts of the body), it is necessary to eliminate all elements of the mollusk. To avoid reinfection (re-infection), you need to regularly treat the affected areas and adjacent skin with antiseptic agents.
— Ekaterina Alexandrovna, tell us about preventive measures. Is it possible to protect yourself from infection with molluscum contagiosum?
— First of all, it is necessary to strictly observe the rules of personal hygiene: wash your hands often with soap or wipe them with antiseptic wipes, do not use other people’s personal hygiene products or clothes, try to avoid tactile contact with infected persons. During sexual contact, no method of barrier contraception can protect against infection with molluscum contagiosum.
Interviewed by Marina Volovik
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For reference:
Krivdina Ekaterina Alexandrovna
Graduate of Kursk State Medical University in 2015, 2016 – internship in dermatovenerology. In 2022, she completed a professional retraining course in the field of “Medical cosmetology” at the Institute of Professional Technologies and Services of the Physics Institute. Works as a cosmetologist at the Expert Clinic Kursk. Reception is conducted at the address: st. Karl Liebknecht, no. 7.
Methods for diagnosing molluscum contagiosum
Molluscum contagiosum can be confused with manifestations of other diseases, including serious ones such as syphilis or cancer. Also, the activity of the molluscum contagiosum virus increases with a decrease in immunity, so in 20% of cases molluscum contagiosum accompanies HIV infection. This means that when rashes appear that correspond to the description of molluscum contagiosum, a medical examination is required to rule out such options.
When contacting a dermatologist, the doctor will examine the patient, make a diagnosis and suggest a treatment method.
Inspection
In most cases, the diagnosis of molluscum contagiosum is made by a dermatologist based on the results of an examination of the patient.
PCR diagnostics
Since HIV often accompanies molluscum contagiosum, PCR diagnostics for HIV can be prescribed.
More information about the diagnostic method
Serological blood test
When molluscum contagiosum is detected in adults, a serological blood test is prescribed to identify sexually transmitted infections (hepatitis B and C, HIV, syphilis, etc.).
More information about the diagnostic method
Sign up for diagnostics To accurately diagnose the disease, make an appointment with specialists from the Family Doctor network.
Causes
Molluscum contagiosum is caused by a virus of the poxvirus family, close to the causative agents of smallpox. The rash on the genitals, buttocks and other parts of the body usually lasts for several months, but sometimes lingers for up to two years before disappearing spontaneously.
This skin condition can be spread from skin to skin or through close contact, shared towels, clothing, shaving equipment, swimming pools, or by scratching the affected area, etc. This skin condition can be sexually transmitted and occurs in the genital and anal areas. In this way they are similar to genital warts. Avoid self-contamination or passing the molluscum to a partner by practicing safe sex or abstaining from sexual contact altogether until the outbreak is treated or eliminated.
Relapses
Unlike the varicella zoster virus (chickenpox), which never truly goes away and can cause herpes zoster (shingles) years later, the molluscum contagiosum virus does not remain after recovery. However, if you come into contact with someone with molluscum contagiosum, you may become infected with the virus again. There is no immunity against molluscum contagiosum.
Prevention
Among adults, the most common method of transmission of shellfish is through sexual contact. Therefore, avoiding sex with someone infected with molluscum contagiosum is a good idea. It should be noted that molluscum contagiosum is considered a less severe sexually transmitted infection, but it is still an STI.
It is difficult to prevent the spread of molluscum contagiosum among children, so this infection is much more common among children.
Treatment methods for molluscum contagiosum
Molluscum contagiosum should be treated by a doctor. You should not try to remove papules yourself - this can lead to bacterial infection.
Treatment of molluscum contagiosum depends on a number of factors, primarily on the stage of development of the disease, the severity of symptoms and the state of the patient’s immunity. The following methods can be used:
Instrumental removal
Papules can be removed instrumentally, followed by treating the wound with antibacterial agents.
Credestruction
Cryodestruction is the removal of papules using exposure to low temperatures. Papules are treated with liquid nitrogen. Tissues treated in this way freeze and die.
Radio wave removal
Molluscum contagiosum papules can be removed using the radio wave method (using the Surgitron apparatus) and using a laser.
Electrocoagulation
Electrocoagulation is the effect of high-frequency current on papules. It is popularly described as “cauterization with electricity.” At the moment of discharge, a local strong thermal effect occurs, the tissues coagulate, which virtually eliminates the risk of infection at the treatment site.
Conservative treatment
The course of treatment for molluscum contagiosum may include conservative treatment with ointments and creams, as well as taking antiviral drugs (if the affected area is large).
Make an appointment Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.
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Symptoms
Infection with the molluscum contagiosum virus causes fluid-filled bumps to appear on the skin.
These bumps range from the size of a pinhead to the size of a pencil eraser. They usually have a small dimple or dimple in the middle. People with weakened immune systems, such as those with HIV/AIDS, may develop large bumps. They may grow to the size of a ruble coin, or they may have clusters of atypical bumps. In most people, lesions caused by molluscum contagiosum are painless. However, they may become itchy, irritated, swollen, or inflamed.
Photo of molluscum contagiosum
If you have molluscum contagiosum on your genitals or other intimate places, it is important to avoid injuring them. Scratching or scratching can spread the virus. Scratches can also make your skin susceptible to secondary infections caused by other bacteria. Molluscum contagiosum infections are usually easy to treat in people with healthy immune systems.
Because molluscum bumps are painless, you may not notice an infection. Visual examination of the genital area, perineum, buttocks and anus is the main way to identify signs of this disease. Molluscum contagiosum cannot be detected by smear or blood tests.
Causes
As mentioned earlier, the disease is caused by a virus, which, according to some experts, belongs to the smallpox virus.
Even in the era of active medical research, it was not possible to get rid of the pathogen. This is due to the fact that it remains in the DNA structure.
But with the help of systemic prevention and strengthening the immune system, relapses are successfully minimized.
Due to reduced immunity, various clinical manifestations are possible. In this case, the localization zone is different.
It all depends on how exactly the infection process occurred.
The main causes of molluscum contagiosum:
- Bad environmental situation. This significantly increases the risk of infectious diseases.
- The AIDS epidemic, unfortunately, is also increasing the number of people getting sick. Many patients diagnosed with HIV have contagious dermatosis.
- An active sex life, which may result in promiscuity regarding sexual partners.
- Densely populated areas are one of the factors for transmitting the virus through contact and household contact.
According to statistics, the virus is often found in children's institutions.
It is also detected in adults during a medical examination. Molluscum contagiosum in babies can affect any area of the skin.
When infected at home, it is difficult to determine the area where the rash occurs.
Infection can even occur due to the use of certain objects.
For example, children often do not even suspect that they are already carriers of viruses. Therefore, molluscum contagiosum is transmitted from one child to another during play.
Description
Molluscum contagiosum is a viral disease that is manifested by the formation of nodules on the skin and mucous membranes.
The disease occurs at any age, mainly in children and adolescents. In adults and older people, the incidence is often associated with decreased immunity, for example, while taking hormonal and antitumor drugs or in HIV-infected people. The virus that causes the disease got its name because of its external similarity to ranovato, and the word “contagious” is translated as “infectious.” Molluscum contagiosum has a contact type of transmission, that is, infection occurs through bodily contact with a sick person or a carrier of the virus - in the pool, while playing contact sports, and also indirectly through common household items - towels, clothes, children's toys, bed linen. Among young people, the sexual type of infection is common.
The disease is caused by 4 types of molluscum contagiosum virus, which differ slightly from each other. However, the first type (which is called “childish”) is found in patients most often - more than 95% of cases of molluscum contagiosum. The second type of virus is specific to the sexual type of transmission of the disease - it accounts for about 3% of all cases. In the body, the virus multiplies exclusively in epithelial cells, and therefore does not cause any serious complications. Currently, molluscum contagiosum can be successfully treated with drug therapy at any stage of the disease.
After infection, the first manifestations of the disease take from one week to several months. During this time, the virus that has penetrated the epithelial cells multiplies in sufficient quantities to trigger an immune response. Typically, elements of molluscum contagiosum in adults can disappear on their own after a few months, even in the absence of treatment. However, in children there is a long course - from six months to 5-6 years.
Diagnostics
Photo: shareably.net
The diagnosis of molluscum contagiosum is based on the clinical picture - the detection of specific nodules on the patient’s skin. However, in cases of atypical forms, scraping of elements will be required for microscopic examination. Using special dyes, large brick-shaped viral bodies are detected under a microscope in epithelial cells.
For the differential diagnosis of molluscum contagiosum, skin diseases such as vulgar warts, flat warts, keratoacanthomas, milia, and acne are excluded.
Treatment
Photo: 1obl.ru
Treatment of molluscum contagiosum has two goals: combating skin manifestations and avoiding relapses of the disease. Since there is a possibility of the molluscum spreading to healthy areas of the skin from existing nodules, it is necessary to treat all elements at the same time. During treatment, the patient should not shave to avoid spreading the molluscum.
Molluscum contagiosum is treated on an outpatient basis. For adult patients without impaired immunity, various methods of destruction of the mollusk are indicated for a quick recovery. For this purpose, the following methods can be used:
- Evisceration, or husking - the mollusk is removed using thin tweezers. This method is recommended for fresh elements and allows you to obtain material for laboratory research.
- Curettage - removal of the affected epithelium is carried out using a curette. This method is painful for the patient and may lead to scarring in the future. With a large number of rashes, the method is ineffective, since it can lead to the appearance of new elements.
- Electrocoagulation – cauterization of mollusks using an electrocoagulator. The method is highly effective due to the targeted effect of electric current.
- Laser therapy – using a laser set to a specific mode, the elements of molluscum contagiosum are destroyed. After laser therapy, it may be necessary to repeat the procedure after 2-3 weeks if the rash persists.
- Cryotherapy – exposure of each element of molluscum contagiosum to liquid nitrogen for 15 seconds. A rather painful procedure, after which it is possible to form blisters at the site of exposure, as well as a violation of skin pigmentation and the appearance of faint scars.
When using any method of destruction of elements of molluscum contagiosum, the use of local anesthesia is indicated to reduce pain and discomfort for the patient. After removing the mollusks, the skin is treated with antiseptic solutions.
People suffering from molluscum contagiosum and having impaired immunity due to other general diseases should be extremely careful about methods that violate the integrity of the skin, as they can lead to infectious complications. When treating a disease in the genital area, frequent changes of underwear are necessary to avoid re-infection.
In young children, with a small number of rashes, treatment can be limited to the topical application of various creams, ointments and antiviral drugs. But this practice is not always effective and parents, after a while, have to agree to a minor, but still surgical intervention. In modern clinics, children are given a patch containing an anesthetic at the site where the molluscum was removed, and after 40-60 minutes, when the drug has taken effect, the element is destroyed using one of the methods described above. In this case, the procedure turns out to be completely painless and low-traumatic, including for the psyche of the child and parents.
Clinical picture of the disease
Molluscum contagiosum is characterized by the appearance of a characteristic rash on the skin and mucous membranes, in most cases without any subjective sensations. Sometimes patients are bothered by itching and burning. Atypical forms of the disease are very rarely recorded.
Localization. The rash in children is localized on the skin of the face (often in the forehead and eyelids), neck, upper chest (including the armpits), upper and lower extremities. Most often, the rash appears on the face, torso, armpits and diaper area. If a rash appears in the genital area, the assumption of sexual abuse should be excluded.
Prevalence. Nodules in the disease are usually single - from 5 to 20 pieces, grouped in one area. In immunodeficiency and in persons with atopic dermatitis, they appear in large numbers, scattered throughout the body.
When scratched, the lesions spread in a linear direction.
Characteristics of the rash. At the beginning of the disease, small (1 - 2 mm in diameter) papules appear on the skin. Gradually they increase in size (up to 5 - 7 mm) and take on the appearance of a dome-shaped nodule. The nodules are hard, flesh-colored or whitish with a pearly sheen. Most of them have a depression in the center, which is clearly visible when magnified. When pressed from the sides, a dense, mushy mass emerges from the nodule, containing keratin and “mollusc bodies” filled with a huge number of virions. In atypical or advanced cases, this sign is absent.
Course of the disease. Molluscum contagiosum is characterized in most cases by self-healing within several months. With constant scratching and the spread of infection to other areas of the skin, nodules appear again and again, and healing is delayed up to 6 - 9 months or more. Sick children are subject to isolation from the children's group until complete recovery.
Complications. Complications of the disease include cases of secondary infection and spread of infection to the eye tissue.
Rice. 5. Scheme of the structure of a nodule in molluscum contagiosum.
Rice. 6. Molluscum contagiosum. Type of rash on the skin.
