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Defining the Future of Dermatology

Molluscum Contagiosum

  • Molluscum Contagiosum
    Molluscum Contagiosum is a skin infection caused by a specific virus. This virus is contagious and can be spread by direct contact.

About

Molluscumcontagiosum

Molluscum contagiosum is a virus that commonly causes dome-shaped papules in children. As the name suggests, it is contagious, with an incubation period of up to 90 days. Cantharidin is one of many treatments for molluscum contagiosum.

Treatment

Treatment

Cantharidin, the active ingredient in Catharone, is a potent blistering agent derived from the dried, powdered blister beetle. This “blister beetle juice” is commonly used to treat molluscum because it is painless upon application and kills warts by forming a blister under the wart separating it from its blood supply. It is applied in the office to specific lesions and allowed to dry. It must be washed off with soap and water 4 hours after application, or sooner if any pain, burning or discomfort occurs.

Treatment Progression (as a general rule, patients can expect the following):
At time of application no pain or discomfort should be experienced.
4 hours: Mild discomfort may occur; wash affected areas with soap and water.
24 hours: Blistering usually forms by 24 hours, separating the wart from its blood supply. The blister is usually filled with clear yellow fluid, but it is not uncommon to have blood in the blister fluid.
4 days: Crusted blister falls off leaving superficial erosions. Treat with Vaseline or Aquaphor twice daily
7 days: Lesions are usually healed with temporary residual inflammation or redness. Temporary loss of normal pigmentation often occurs, but usually no scarring.

Although most patients note little discomfort, some may experience tingling, itching, or burning. The area may be tender for several days. Acetaminophen or ibuprofen may be given for discomfort. Soaking the area with cool water compresses may also provide relief. If present, a blister may be punctured with a sterile needle if it is uncomfortable. Otherwise, leave the blistered skin intact to provide a natural band-aid.

It is not uncommon to need repeated treatments and although highly effective, Cantharone will not work for all lesions. Appointments should be scheduled at 4-6 week intervals for optimal results.

Commonly your provider may also provide an at-home medication, imiquimod (aldara) to use after your skin has recovered from the cantharidin (approximately 7-14 days after the cantharidin treatment). This medication comes in small packets and a pin should be used to open the packets to avoid spilling the contents. This medication should be used initially three times weekly at night but may be increased to five times weekly at night if no irritation develops. The medication should be washed off in the morning.

Please call the office if you have any questions about your therapy.


FAQs

How is molluscum transmitted?

Molluscum contagiosum virus (MCV) is transmitted by skin-to-skin contact of the lesions.

MCV may be transmitted from inanimate objects such as towels and clothing that come in contact with the lesions. MCV transmission has been associated with swimming pools and sharing baths with an infected person.

MCV also may be transmitted by auto inoculation - touching a lesion and touching another part of the body. To prevent spreading the infection further, do not shave over or close to lesions, and do not pick at sites that are visibly infected.

What is the incubation period?

The incubation period averages 2 to 3 months and may range from 1 week to 6 months.

How long are you infectious?

This is not known for certain, but researchers assume that if the virus is present, it may be transmitted.

What are the symptoms?

Children typically develop lesions on the face, trunk, legs and arms.

In adults, lesions are usually present on the thighs, buttocks, groin and lower abdomen.

The lesions may begin as small bumps which can develop over a period of several weeks into larger sores/bumps. The lesions can be flesh colored, gray-white, yellow or pink. They can cause itching or tenderness in the area, but in most cases the lesions cause few problems. Lesions can last from 2 weeks to 4 years—the average is 2 years.

People with compromised immune systems may develop extensive outbreaks.

How is it diagnosed?

Diagnosis is usually made by the characteristic appearance of the lesion. However, if the lesion does not have the typical features of molluscum, because it is irritated, or is not in a typical place, it may require a biopsy to diagnose.

How is it treated?

Most symptoms are self-resolving, but generally lesions are treated with a destructive technique. Treatment of lesions reduces auto inoculation and transmission to others.

Destructive therapies include topical medications applied in the office to intentionally irritate the lesions or cryotherapy which freezes and kills the infected skin cells.

Lesions may recur, but it is not clear whether this is due to reinfection, exacerbation of subclinical infection, or reactivation of latent infection.

What does it mean for my health?

In children, the lesions are harmless and does not typically reflect any underlying health issues. In adults, your health care provider will discuss potential associated diseases, if necessary.

How can I reduce my risk?

In children, infected siblings should not bathe with or share towels with other siblings. In between treatments, covering the lesions with liquid band-aids can decrease the risk of spreading the virus. Additionally, treating dry skin and eczema is important as the virus enters and infects skin that is cracked and damaged.

Because transmission through sexual contact is the most common form of transmission for adults, preventing skin-to-skin contact with an infected partner will be most effective in preventing MCV.

If you do get molluscum contagiosum, avoid touching the lesion and then touching another part of the body without washing your hands to prevent any chance of spreading the infection.

Source:

Centers for Disease Control and Prevention

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