From the Guidelines
Molluscum contagiosum is a viral infection that causes lesions on the skin, including the eyelids, and can lead to conjunctivitis and keratitis due to viral shedding onto the surface of the eye.
Key Characteristics
- Typically unilateral, but can be bilateral 1
- Causes mild to severe follicular reaction, punctate epithelial keratitis, and may have corneal pannus, especially if long-standing 1
- Predominantly affects older children and young adults, but can also occur in immunocompromised individuals, such as those with HIV 1
- Characterized by single or multiple shiny, dome-shaped umbilicated lesions on the eyelid skin or margin 1
Treatment and Management
- Treatment options include incision and curettage, simple excision, excision and cautery, and cryotherapy 1
- Reduction of the viral load often allows the host immunologic response to eliminate residual virus, but follow-up may be necessary if conjunctivitis persists 1
- Referral to a dermatologist may be necessary for examination of other suspicious lesions 1
From the Research
Definition and Causes of Molluscum Contagiosum
- Molluscum contagiosum is a viral infection caused by the molluscum contagiosum virus (MCV) [ 2, 3, 4, 5 ].
- It is a self-limited infectious dermatosis that can affect anyone, but is more common in pediatric populations, sexually active adults, and immunocompromised individuals [ 3, 4, 5 ].
- The virus is transmitted mainly through direct contact with infected skin, which can be sexual, non-sexual, or autoinoculation [ 3, 5 ].
Clinical Presentation and Diagnosis
- Molluscum contagiosum presents as firm, rounded papules that are pink or skin-colored, with a shiny and umbilicated surface [ 3 ].
- The duration of the lesions can vary, but they are typically self-limited and resolve within 6-9 months [ 3, 4 ].
- Diagnosis is based on clinical findings, and dermoscopy can be a useful tool [ 3 ].
- If diagnostic doubt persists, confocal microscopy or skin biopsy may be performed [ 3 ].
Treatment and Management
- The need for active treatment of molluscum contagiosum is controversial, but it is generally recommended for cases with extensive disease, associated complications, or aesthetic complaints [ 3, 4 ].
- Treatment options include mechanical, chemical, immunomodulatory, and antiviral therapies [ 3 ].
- Only one treatment, a drug-device product using topical cantharidin, is approved by the US Food and Drug Administration (FDA) for the treatment of molluscum contagiosum [ 4 ].