Molluscum contagiosum

Last updated: December 13, 2022

Summarytoggle arrow icon

Molluscum contagiosum is a common localized skin infection caused by the molluscum contagiosum virus that often occurs on the trunk, face and genitalia. It is more common in childhood as well as early adolescence, particularly in males, and is usually transmitted at this age via skin contact and autoinoculation. In adults, it is considered a sexually transmitted infection. Lesions appear as smooth, dome-shaped papules with central umbilication. In healthy patients, molluscum contagiosum is generally self-limiting and heals spontaneously after several months. However, in immunosuppressed individuals, lesions can be very large, widespread, and persistent. If treatment is indicated (e.g., for sexually transmitted molluscum contagiosum), cryotherapy with liquid nitrogen is usually the first treatment option.

Epidemiologytoggle arrow icon

  • Sex: >
  • Age: most common in childhood (peak incidence < 5 years of age) and early adolescence
  • Prevalence
    • More common in warm and humid climates or areas with poor hygiene
    • Up to 20% of HIV-positive patients have symptomatic infection [1]

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

Suspect AIDS if large, persistent, widespread lesions appear on an adult!

Clinical featurestoggle arrow icon

Diagnosticstoggle arrow icon

  • Clinical diagnosis [3]
  • Seek out underlying etiologies (i.e., HIV testing) if lesions in adults and/or widespread
  • A biopsy is usually not necessary, but consider in cases of immunosuppression, as the diagnostic differential is wide (see “Differential diagnosis” below).

Pathologytoggle arrow icon

Histology [3]

Differential diagnosestoggle arrow icon

The differential diagnoses listed here are not exhaustive.

Treatmenttoggle arrow icon

Spontaneous remission of the lesions usually happens within a few months; thus, treatment is often unnecessary. [3][5]

Complicationstoggle arrow icon

We list the most important complications. The selection is not exhaustive.

Referencestoggle arrow icon

  1. Hanson D, Diven DG. Molluscum contagiosum.. Dermatol Online J. 2003; 9 (2): p.2.
  2. Berger EM, Orlow SJ, Patel RR, Schaffner JV. Experience With Molluscum Contagiosum and Associated Inflammatory Reactions in a Pediatric Dermatology Practice. Arch Dermatol. 2012; 148 (11): p.1257-1264.doi: 10.1001/archdermatol.2012.2414 . | Open in Read by QxMD
  3. Chen X, Anstey AV, Bugert JJ. Molluscum contagiosum virus infection. Lancet Infect Dis. 2013; 13 (10): p.877-888.doi: 10.1016/s1473-3099(13)70109-9 . | Open in Read by QxMD
  4. Chronic Follicular Conjunctivitis. Updated: January 1, 2016. Accessed: December 31, 2016.
  5. Gerlero P, Hernández-Martín Á. Actualización sobre el tratamiento de moluscos contagiosos en los niños. Actas Dermosifiliogr. 2018; 109 (5): p.408-415.doi: 10.1016/ . | Open in Read by QxMD
  6. Isaacs SN, Hirsch MS, Levy ML, Rosen T, Ofori AO. Molluscum contagiosum. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. Last updated: August 1, 2016. Accessed: December 31, 2016.

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