How is molluscum contagiosum recognised and treated?

Molluscum contagiosum is a papular rash caused by a viral skin infection. The condition is most common in children between 2 and 5 years of age. Papules usually occur on the face, trunk and back of the hands but can occur anywhere. The virus is spread by direct contact with other children. Molluscum contagiosum is common and often extensive in children infected with HIV. In these children with a weak immune system, the papules may be large and not respond to standard treatment.

The molluscum papules have a typical, easily recognised appearance. They are pearly white and dome shaped with a central dimple. The papules vary in size but usually are as big as a match head. The rash is not itchy or painful, and usually clears spontaneously leaving no scars. Secondary bacterial infection of the papules can occur causing inflammation and pain.

It is best to leave them alone as they will disappear on their own after a few months. However, they can be treated by pricking each papule with a sharp stick (tooth pick). If necessary the contents can be gently squeezed out. With many papules, sedation or a general anaesthetic may be needed before treatment. Wart paint, benzoyl peroxide or liquid nitrogen have also been used.

Many common, mild skin infections may become severe and persistent in children with HIV infection.

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