What is the typical age of onset for molluscum contagiosum?

Age of Onset for Molluscum Contagiosum

The typical age of onset for molluscum contagiosum is primarily in preschool and elementary school-aged children, with a mean age of 4.8 years in warmer climates. 1, 2

Epidemiology and Age Distribution

• Molluscum contagiosum is a common viral cutaneous infection that affects children worldwide 1
• Age distribution varies by geographic region and climate:
  • In warmer climates like Greece, the peak incidence occurs at a younger age (mean 4.8 years) 2
  • In cooler climates, the peak incidence tends to be in older children (10-12 years) 2
• The condition is caused by a poxvirus of the Molluscipox genus 1

Age-Related Clinical Presentation

The clinical presentation of molluscum contagiosum varies by age:

• In children ≤2 years: Lesions are primarily located on the face 2
• In older children: Lesions are predominantly found on the trunk 2
• Typical presentation includes asymptomatic, discrete, smooth, flesh-colored, dome-shaped papules with central umbilication 1

Risk Factors

• Atopic dermatitis is a significant predisposing factor for molluscum contagiosum (18.2% of affected children vs. 5% of general pediatric population) 2
• Transmission occurs through:
  • Close physical contact
  • Autoinoculation
  • Fomites (contaminated objects) 1

Clinical Course

• Molluscum contagiosum is generally a benign, self-limiting infection 3
• Spontaneous resolution typically occurs within 6-12 months, although complete resolution can take up to 4 years 4
• In immunocompetent children, the condition usually resolves without intervention, though treatment may be considered for cosmetic reasons or to prevent spread 1

Special Considerations

• Multiple or persistent lesions in otherwise healthy children rarely indicate immunodeficiency 2
• The American Academy of Pediatrics recommends observation for asymptomatic, limited lesions in immunocompetent patients 4
• Lesions near the eyes require prompt treatment to prevent ocular complications 4
• Evaluation for immunocompromised state should be considered in adults with large and multiple lesions 4

Understanding the typical age of onset helps clinicians recognize and appropriately manage this common childhood viral infection, with treatment decisions based on the patient's age, number and location of lesions, and parental preferences.