Molluscum Contagiosum

Molluscum Contagiosum is a viral skin infection, caused by a common pox virus. In adults with a healthy immune system they are usually transmitted by close physical contact, including sexual, and usually appear on the genital areas or thighs. But for children, irrespective of HIV status and people with HIV they can also appear and spread to anywhere on the body, particularly the face (usually made worse by wet shaving). About 10-20% of people with symptomatic HIV infection develop Molluscum.

Transmission
Transmission is by touch or close contact, including sexual contact. The incubation period is normally from several weeks to several months. Although molluscae themselves are not dangerous they are contagious, both from person to person and for someone who has molluscum, they can spread them to other parts of their own body simply by touching. This is why it is important not to scratch or pick at them.

Symptoms
The symptoms of molluscum contagiosum are easily identifiable:

* firm bumps which are about 2-4 mm in diameter;
* milky-white, pearly or waxy looking;
* Indented in the middle (like a doughnut);

When these are sexually transmitted, they are frequently found on the genitals, thighs and buttocks, but as stated earlier, they can also appear anywhere on the body. The bumps can remain for months and then disappear. However in people who are immunosupressed, they can often remain indefinitely, unless they are treated.

Diagnosis
Diagnosis of molluscum is usually made by inspection by a clinician. They can sometimes be confused with warts caused by HPV (human papilloma virus), but if in any doubt the doctor can take a sample for further examination.

Treatment
Treatment is done primarily for cosmetic reasons and to prevent the spread of infection. The aim of all the treatments is to remove the lesions but in particular the hard root. The most commonly used treatment is to spray with liquid nitrogen in a process called cryotherapy. This kills the cells of the molluscum and it often requires more than one treatment, over a couple of weeks. There are other forms of treatment involving the use of chemicals (trichloroacetic acid, as well as anti-wart solutions containing podophyllotoxin). Patients on combinations of anti-HIV medication often find that as the HIV is suppressed their molluscae improve without specific treatment.

How to prevent the spread
There are a number of things you can do that might help reduce the spread of molluscae from one part of your body to another. Do not pick at them, or try to remove them yourself, as this is a sure-fire way of spreading them, and they can easily become infected. If you do accidentally touch them or scratch them (as they can be itchy) wash your hands straight away. If you are a man, you could try to use an electric razor rather than wet shave your face, and use an iodine-based face wash, which will inhibit the spread.