Molluscum Contagiosum in Emergency Medicine Follow-up

  • Author: Peter P Taillac, MD; Chief Editor: Pamela L Dyne, MD   more...
 
Updated: Jul 2, 2008
 

Deterrence/Prevention

  • Physical contact with infected individuals should be avoided. Sharing of clothing and towels should be avoided.
  • Most of the adolescent and adult cases are secondary to sexual contact. Abstinence and careful selection of sexual partners are important. It is unclear if condoms are effective in preventing the spread of molluscum contagiosum.
  • Good personal hygiene is a key factor in avoiding transmission of this disease.
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Complications

  • Bacterial superinfection
    • Staphylococcus aureus
    • Staphylococcus epidermidis
    • Streptococcus species
  • Autoinoculation
  • Contagious to others
  • Possible extensive infections in immunocompromised individuals
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Prognosis

  • The prognosis generally is excellent since the disease usually is self-limited.
  • In immunocompetent patients, the lesions generally last for 2-4 weeks. The disease usually resolves completely in 2-4 years.
  • Recurrences of lesions can occur after the initial clearing in as many as 35% of patients. This is of unknown significance because it may represent reinfection, exacerbation of ongoing disease, or new lesions arising after a prolonged latent period.
  • In patients who are infected with HIV or are otherwise immunocompromised, the disease often becomes more generalized, more prolonged, and resistant to treatment. Antiretroviral therapy to restore immune system function has been found to improve MCV infection.
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Patient Education

  • For infection in children, the benign nature of this ubiquitous disease should be stressed. However, it can be embarrassing and unsightly for the patient.
  • Limiting physical contact with infected individuals and improving personal hygiene should reduce transmission and autoinoculation of the virus.
  • Parents should be instructed to watch for possible superinfection (eg, bacterial), which occurs in up to 40% of all cases.
  • It is not necessary to keep infected children out of school, although physical contact and sharing of clothes and towels should be discouraged. Sharing of baths should also probably be avoided. Daycare centers may refuse patients with uncovered lesions.
  • This disease usually is sexually transmitted in adolescent and adult patient populations, although casual contact may also result in transmission. Safe sex practices and/or abstinence should be discussed, although it is unclear whether condoms and other barrier methods provide adequate protection against the transmission of molluscum contagiosum.
  • Patient educators must stress that not all sexually transmitted diseases are as benign as molluscum contagiosum (eg, herpes simplex, gonorrhea, chlamydia, HIV). Abstinence should be practiced until lesions resolve. In patients with multiple sexual partners and/or other risk factors, HIV testing is strongly recommended.
  • It is important to note that not all cases in adults are sexually transmitted. Casual skin contact can also result in infection. This diagnosis could cause significant relationship stress.
  • For excellent patient education resources, visit eMedicine's Skin, Hair, and Nails Center and Pregnancy and Reproduction Center. Also, see eMedicine's patient education articles Molluscum Contagiosum, Birth Control Overview, and Birth Control FAQs.
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Contributor Information and Disclosures
Author

Peter P Taillac, MD  Associate Clinical Professor of Surgery, Division of Emergency Medicine, University of Utah Health Sciences Center

Peter P Taillac, MD is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Eric M Kardon, MD, FACEP  Attending Emergency Physician, Georgia Emergency Medicine Specialists; Physician, Division of Emergency Medicine, Athens Regional Medical Center

Eric M Kardon, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Mark W Fourre, MD  Program Director, Department of Emergency Medicine, Maine Medical Center; Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD  Professor of Clinical Medicine/Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center

Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References

  1. Mathes EF, Frieden IJ. Treatment of molluscum contagiosum with cantharidin: a practical approach. Pediatr Ann. Mar 2010;39(3):124-8, 130. [Medline].

  2. Brown M, Paulson C, Henry SL. Treatment for anogenital molluscum contagiosum. Am Fam Physician. Oct 15 2009;80(8):864. [Medline].

  3. Dohil M, Prendiville JS. Treatment of molluscum contagiosum with oral cimetidine: clinical experience in 13 patients. Pediatr Dermatol. 1996;13(4):310-2. [Medline].

  4. Meadows KP, Tyring SK, Pavia AT. Resolution of recalcitrant molluscum contagiosum virus lesions in human immunodeficiency virus-infected patients treated with cidofovir. Arch Dermatol. 1997;133(8):987-90. [Medline].

  5. Syed TA, Lundin S, Ahmad M. Topical 0.3% and 0.5% podophyllotoxin cream for self-treatment of molluscum contagiosum in males. A placebo-controlled double-blind study. Dermatology. 1994;189(1):65-8. [Medline].

  6. Binder B, Weger W, Komericki P, Kopera D. Treatment of molluscum contagiosum with a pulsed dye laser: Pilot study with 19 children. J Dtsch Dermatol Ges. Feb 2008;6(2):121-5. [Medline].

  7. Braue A, Ross G, Varigos G. Epidemiology and impact of childhood molluscum contagiosum: a case series and critical review of the literature. Pediatr Dermatol. Jul-Aug 2005;22(4):287-94. [Medline].

  8. Brown J, Janniger CK, Schwartz RA. Childhood molluscum contagiosum. Int J Dermatol. Feb 2006;45(2):93-9. [Medline].

  9. Coloe J, Burkhart CN, Morrell DS. Molluscum contagiosum: what's new and true?. Pediatr Ann. Jun 2009;38(6):321-5. [Medline].

  10. Dohil MA, Lin P, Lee J. The epidemiology of molluscum contagiosum in children. J Am Acad Dermatol. Jan 2006;54(1):47-54. [Medline].

  11. Leslie KS, Dootson G, Sterling JC. Topical salicylic acid gel as a treatment for molluscum contagiosum in children. J Dermatolog Treat. 2005;16(5-6):336-40. [Medline].

  12. Luisto M. Unusual and iatrogenic sources of tetanus. Ann Chir Gynaecol. 1993;82(1):25-9. [Medline].

  13. Ordoukhanian E, Lane AT. Warts and molluscum contagiosum: Beware of treatments worse than the disease. Postgrad Med. 1997;101(2):223-35. [Medline].

  14. Peter G, ed. American Academy of Pediatrics, Molluscum Contagiosum. In: Red Book: Report on the Committee on Infectious Diseases. 24th ed. 1997:364.

  15. Scheinfeld NS. Molluscum contagiosum. Skinmed. Mar-Apr 2008;7(2):89-92. [Medline].

 
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Typical molluscum lesions on buttocks. Photo courtesy of F. Fehl III, MD.
Molluscum lesions on face and neck. Photo courtesy of F. Fehl III, MD.
 
 
 
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