Molluscum contagiosum virus (also known as MCV) is a viral skin infection that is common among children, ranging from 1-4 years old, who are predisposed to allergic diseases (atopy) and therefore have a more fragile immune system. In adolescents and adults, especially those who are immunocompromised (patients with AIDS, transplants, on dialysis, with tumors or undergoing prolonged treatment with corticosteroid drugs), transmission occurs primarily through sexual intercourse if the partner has lesions on the genital mucosa (differential diagnosis with genital herpes) or through direct contact with infected skin (always wash your hands thoroughly!). It can also be transmitted through the promiscuous use of infected sheets, towels, or underwear, and the sharing of bathtubs or showers with people infected with molluscum contagiosum. It is an extremely contagious, but fortunately benign, infection. Hot climates and humidity facilitate contagion.
The strange name “molluscum” that identifies the infection comes from the Latin word molluscus, which means soft. In fact, the lesions caused by this virus have a soft, rather spongy appearance. They are small raised lesions with a dimple in the center, which appear after a variable incubation period of 2 to 7 weeks. They can vary by number (from a couple to over a hundred), by size (2-15 mm) and by color (white, yellow, gray, skin-colored). The lesions can spread across the body’s surface (without damage to the internal organs), although in most affected subjects they appear on the face, armpits, arms, hands and groin. The infection does not affect either the palm of the hands or the soles of the feet.
Generally, they do not cause any symptoms. Particularly sensitive subjects complain of itching, inflammation, secondary infections and conjunctivitis. In subjects with severe immunological impairment, lesions assume atypical aspects in terms of number, morphology, and localization.
The diagnosis is clinical, and is done through careful, direct observation of the papular lesions. Eventually, if the diagnosis is uncertain, it can be confirmed by a skin biopsy.
In healthy subjects, the lesions may regress spontaneously, but healing often requires long waiting times (months/years). It is more complicated for immunosuppressed patients, who often have lesions that are more severe and more difficult to eradicate, even using a pharmacological approach.
Drug therapy involves local application of keratolytic, antiviral or immunosuppressive drugs. In the most aggressive, hard-to-eradicate cases, the lesions are surgically removed by curettage, cryotherapy (cold therapy) or laser therapy to prevent autoinfection or sexual infection. To minimize the risk of possible recurrences, treatment should be started immediately, when the lesions are few and of small dimension.
Using a condom does not completely protect against infection. Molluscum contagiosum genital lesions are generally not restricted to the location covered by the condom, but may spread to many areas of the skin.
