General Medical Information

Molluscum Contagiosum

Wilberto Nieves-Neira
Bhagirath Majmudar
Ira R. Horowitz

Molluscum contagiosum is seen most frequently in children, usually on the face, trunk, and extremities. Vulvar lesions can result from autoinoculation from other parts of the body or from close contact (sexual or nonsexual) with an affected individual. In the child, molluscum produces the classic, slightly elevated, waxy, 2- to 5-mm diameter nodules with a central umbilication. The umbilication contains a pulpy core that can be removed. The lesions are asymptomatic and can be recognized by either the child or the mother. The diagnosis is confirmed by cytology or biopsy as prominent viral inclusions (molluscum bodies) are visualized. The biopsy can be performed using a small Keys punch biopsy device with the patient under local anesthesia. Many molluscum infections will resolve spontaneously over a 6- to 12-month period. Cryotherapy with application of liquid nitrogen using a cotton applicator can be performed every 3 weeks until the lesions resolve. Curettage of the central core of each lesion with the patient under local anesthesia is effective and provides a surgical pathology specimen. Scratching of the lesions is an important mode of spreading the disease by autoinoculation.