eMedicine Specialties > Emergency Medicine > Dermatology
Molluscum Contagiosum: Follow-up
Updated: Jul 2, 2008
Follow-up
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.
Complications
- Bacterial superinfection
- Staphylococcus aureus
- Staphylococcus epidermidis
- Streptococcus species
- Autoinoculation
- Contagious to others
- Possible extensive infections in immunocompromised individuals
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.
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.
Miscellaneous
Medicolegal Pitfalls
- Failure to consider child abuse in children with genital lesions.
- Failure to consider an undiagnosed immunocompromised state in a patient with extensive disease or in a patient whose condition fails to respond to usual therapy.
The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Stephen Bretz, MD, to the development and writing of this article.
More on Molluscum Contagiosum |
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| Multimedia: Molluscum Contagiosum |
| References |
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References
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