HIV/AIDS

07 May 2003

Molluscum contagiosum

Molluscum contagiosum is a skin infection caused by a pox virus. The infection produces pearly nodules that can occur in clusters anywhere on the body. Although it normally only affects children, among adults with HIV/Aids, the infection can be extensive.

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Summary

  • Molluscum contagiosum is a skin infection caused by a pox virus.
  • The infection produces pearly nodules that can occur in clusters anywhere on the body.
  • Molluscum contagiosum is easily spread by close skin-to-skin contact.
  • In the general population, Molluscum contagiosum usually affects children.
  • Among adults with HIV/Aids, the infection can be extensive.
  • Although the lesions go away on their own, treatment is recommended to prevent the infection from spreading.

What is molluscum contagiosum?
Molluscum contagiosum is a skin infection which is usually a minor childhood problem, but in people with Aids it can be extensive and unsightly.

Molluscum contagiosum is caused by a pox virus (a group of viruses that cause characteristic skin lesions called "pocks"). Molluscum lesions develop after the virus enters the body through tiny breaks in the skin or hair follicles and infects the outer layers of the skin. Fortunately, the infection is restricted to the skin and does not affect internal organs.

Symptoms of molluscum contagiosum
The lesions of molluscum contagiosum are pearly, pink or flesh-coloured nodules in the skin. Each nodule has a core of cheesy material. The nodules are painless, can vary in size, and occur in clusters on the face and/or anywhere on the body. They are more often found on parts of the body where areas of skin come into contact with one another, such as the creases of the groin or arm.

How is molluscum contagiosum transmitted?
The virus is easily spread by close skin-to-skin contact – as the name “contagiosum” implies. Less frequently, it is possible to get the virus while swimming in a contaminated pool or by touching objects that have come into contact with someone who has infected skin. The more often a person comes into contact with the virus, the greater the chance they will develop molluscum lesions. When lesions occur in the genital area, it is possible for molluscum to be transmitted through sexual contact.

How does molluscum contagiosum affect people with HIV/Aids?
People with HIV/Aids have compromised immune systems and as a result are especially at risk to molluscum contagiosum infection and to developing the lesions. The lesions tend to be bigger and more numerous in people with HIV infections, may be found on the face, and take longer to heal.

How is molluscum contagiosum diagnosed?
Molloscum contagiosum can be diagnosed by studying cells from the lesion under a microscope. This procedure is not usually necessary, however, as the growths have specific characteristics that can quite easily be identified.

How is molluscum contagiosum treated?
Treatment may be necessary if the nodules occur in an awkward place, such as on the eyelid, but is mainly requested because the condition is unsightly. Treatment can involve pricking each nodule with a toothpick dipped in phenol, or by freezing each nodule with liquid nitrogen.

Other methods of treatment include cauterization with an electric needle, laser therapy, or scraping off the nodule with a sharp instrument. These methods can be slightly painful and if there are many growths a number of treatment sessions may be required. In some countries, it may be possible through a specialist centre to obtain topical treatment in the form of an anti-viral gel that can be applied directly onto the infected areas on a daily basis.

While molluscum lesions do go away of their own accord, in people with compromised immune systems they are more persistent. Treatment is recommended because the lesions are contagious and are likely to spread to other areas of the skin. The nodules often become reddened and inflamed before healing and do not leave any permanent scars or tissue damage. However, if left alone, the lesions can take up to several years before they completely disappear. The earlier the nodules are treated, the greater the chances of controlling the condition and preventing them from spreading.

 

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HIV/Aids expert

Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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