Sexually Transmitted Infections : Molluscum Contagiosum

Introduction

• Description: Molluscum contagiosum is a papillary lesion caused by viral infection (poxvirus) that is spread by skin-to-skin contact, first described in 1817.

• Prevalence: 2/100,000; 1 of 40–60 patients with gonorrhea; approximately 1% of all skin disorders in the United States.

• Predominant Age: Early reproductive age.

• Genetics: No genetic pattern. The virus shares one-half of the genes found in variola and vaccinia viruses.

Etiology and Pathogenesis

• Causes: Molluscum contagiosum is caused by the largest member of the poxvirus group. This mildly contagious DNA virus infects epithelial tissues, and autoinoculation to other sites is common. The appearance of lesions ranges from 1 week to 6 months, with an average incubation period of 2–6 weeks. The virus can also infect other primates and kangaroos.

• Risk Factors: Sexual activity and direct exposure to the infective agent. Infection with human immunodeficiency virus (HIV) or immunocompromise increases the risk of infection if exposed.

Signs and Symptoms

• Asymptomatic.

• After several weeks of incubation, a round, umbilicated papule, 1–5 mm in size, with a yellow, waxy core of cheesy material (these lesions may grow slowly for months; they may be solitary or occur in clusters) that may occur anywhere on the body except the palms and soles.

• Eczema (10%).

• The lesions of molluscum are highly contagious, and appropriate precautions should be used when examining the lesions or material from the lesions to avoid infection or spread.

Diagnostic Approach