eMedicine Specialties > Pediatrics: General Medicine > Dermatology

Molluscum Contagiosum: Follow-up

Author: Mark A Crowe, MD, Assistant Clinical Instructor, Department of Medicine, Division of Dermatology, University of Washington School of Medicine
Contributor Information and Disclosures

Updated: Aug 5, 2009

Follow-up

Further Outpatient Care

  • Retreatment is often necessary in patients with molluscum contagiosum (MC) virus (MCV).

Deterrence/Prevention

  • Most cases in adolescents and adults are secondary to sexual contact. Abstinence and careful selection of sexual partners are important. Whether condoms are effective in preventing spread is unclear.
  • Good personal hygiene is important in limiting transmission.
  • Autoinoculation may result from trauma, such as shaving or manipulation of lesions by the patient.

Complications

  • Complications include irritation, inflammation, and secondary infections.
  • Lesions on eyelids may be associated with follicular or papillary conjunctivitis.
  • Bacterial superinfection may occur but is seldom of clinical significance.
  • Autoinoculation is possible.
  • Infection may be transmitted to others.
  • Immunocompromised individuals may have extensive cutaneous infections.

Prognosis

  • Prognosis is generally excellent because the disease is usually benign and self-limited.
  • In healthy patients, treatments are usually effective.
  • Lesions can be disfiguring and produce anxiety in the patient, family, and daycare facility or school.
  • Recurrences occur in as many as 35% of patients after initial clearing. The significance of these recurrences is unknown. They may represent reinfection, exacerbation of ongoing disease, or new lesions arising after a prolonged latent period.
  • The disease often becomes generalized in patients who are infected with HIV or are otherwise immunocompromised. A direct correlation has been found between increasing severity of the disease and lower CD4 counts.

Patient Education

  • Stress the benign nature of this ubiquitous disease to the patient and parents.
  • Limiting physical contact with infected areas of skin and good handwashing may reduce transmission.
  • Instruct the patient to avoid scratching, which may result in autoinoculation.
  • Keeping children out of school is not necessary; however, discourage physical contact and sharing of clothes and towels. In smaller children in whom physical contact is more difficult to prevent, keeping infected areas covered with clothing is reasonable. Cover exposed lesions with tape or an adhesive bandage. Infection of other children cannot be completely prevented. Because the disease is extremely common and of very little clinical significance, the decision to limit infected children from daycare centers must be approached on a case-by-case basis.
  • In adolescent and adult patient populations, this disease is usually sexually transmitted. Encourage safe sex and abstinence; however, whether condoms and other barrier methods provide adequate protection against transmission is unclear.
  • Emphasize that not all sexually transmitted diseases (STDs) are as benign as molluscum contagiosum virus (eg, herpes simplex, gonorrhea, chlamydia, HIV). Stress adherence to abstinence until lesions resolve. In the patient with multiple sexual partners or other risk factors, HIV testing is strongly recommended.
  • Note that not all cases in adults are sexually transmitted. This diagnosis can cause significant relationship stress.
  • For excellent patient education resources, visit eMedicine's Procedures Center and Skin, Hair, and Nails Center. Also, see eMedicine's patient education articles Molluscum Contagiosum, Birth Control Overview, and Birth Control FAQs.

Miscellaneous

Medicolegal Pitfalls

  • Infection of children through sexual abuse is possible; however, to a greater extent than warts, molluscum contagiosum virus (MCV) is quite common on the genital, perineal, and surrounding skin of children.47,48 Regard abuse as unlikely, unless other suspicious features are present.
  • Histological or microscopic confirmation of molluscum contagiosum is indicated in patients who are immunocompromised because several life-threatening opportunistic infections may clinically mimic molluscum contagiosum.
 


More on Molluscum Contagiosum

Overview: Molluscum Contagiosum
Differential Diagnoses & Workup: Molluscum Contagiosum
Treatment & Medication: Molluscum Contagiosum
Follow-up: Molluscum Contagiosum
Multimedia: Molluscum Contagiosum
References
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Further Reading

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Keywords

molluscum contagiosum, MC, molluscum contagiosum virus, MCV, molluscum verrucosum, molluscum contagiosum cornutum, viral infection, Poxviridae, HIV infection, Koebner phenomenon, psoriasis, lichen planus, atopic dermatitis, sexually transmitted disease, STD, acquired immunodeficiency syndrome, AIDS, Henderson-Paterson bodies, poxvirus, keratoconjunctivitis, atopy, eczema, asthma, hayfever, epidermal cysts, nevocellular nevi, sebaceous hyperplasias, Kaposi sarcoma, sarcoidosis, lymphocytic leukemia, thymoma, orthopoxvirus, parapoxvirus, pseudocystic molluscum contagiosum, giant molluscum contagiosum, syphilis, gonorrhea

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Contributor Information and Disclosures

Author

Mark A Crowe, MD, Assistant Clinical Instructor, Department of Medicine, Division of Dermatology, University of Washington School of Medicine
Mark A Crowe, MD is a member of the following medical societies: American Academy of Dermatology and North American Clinical Dermatologic Society
Disclosure: Nothing to disclose.

Medical Editor

Kevin P Connelly, DO, Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center
Kevin P Connelly, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

CME Editor

Merrily P M Poth, MD, Professor, Department of Pediatrics and Neuroscience, Uniformed Services University of the Health Sciences
Merrily P M Poth, MD is a member of the following medical societies: American Academy of Pediatrics, Endocrine Society, and Lawson-Wilkins Pediatric Endocrine Society
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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