Common Lumps & Bumps – Molluscum Contagiosum
What are they?
Molluscum contagiosum is an infection of the epithelial cells of the skin. This is caused by the molluscum contagiosum virus (MCV). The lesions are characteristically small (2-5mm), raised, filled with a caseous (cheese-like) whitish substance and occur in crops. They often have a central indentation in them (umbilicated appearance). Molluscum lesions are generally pearly white or skin colored. They may occur on any part of the body, save the palms and soles.
Most molluscum lesions are self limiting, lasting for approximately 6 months or so. While most do not cause any problems, some may be associated with itchiness or mechanical discomfort ( lying in an area prone to friction etc). On occasion, the lesions may be inflamed secondary to an opportunistic infection.
Why do I get them?
Molluscum lesions are transmitted by skin to skin contact. This may occur from person to person or from one part of your skin to another. Lesions around the groin may be transmitted during sexual contact.
Are they dangerous?
Molluscum lesions do not pose a threat. They are generally self limiting and do not have any risk of malignant (cancerous) transformation. Occasionally a single lesion may be difficult to distinguish from basal cell carcinoma, a form of skin cancer. In this circumstance, a biopsy and study of the tissue may be warranted. It is also of note that extremely large or numerous lesions may be indicative of underlying HIV disease.
What should I do?
Molluscum lesions may be removed for a variety of reasons: for cosmesis or for relief of physical symptoms such as itch or irritation. Generally, it is advised that all genital lesions, whether symptomatic or not, are removed. You may wish to try topical preparations such as imiquiod cream.
It is also prudent to note that unusually large crops or large individual lesions may be associated with underlying HIV. You may wish to consult your doctor about the need to test for HIV and other STIs
How do I remove them?
When, in the rare instances, there is a need to exclude other malignant lesions such as basal cell carcinoma, a punch biopsy of the lesion and the underlying skin is preferred. The remaining defect is sutured close and left to heal. You will need a follow-up appointment in 10-14 days time for removal of the sutures.
Most times however, such drastic removal is not needed. Very often, cryotherapy is used to treat lesions. This can be done in the outpatient setting with no need for previous preparation or anaesthesia. You may need a few sessions to satisfactorily treat the lesions.
Occasionally some lesions may be removed via curetting or radiofrequency ablation. These are outpatient procedures with no need for previous preparation. Rarely there may be need for localized anaesthesia; however most small lesions may be removed without anaesthesia. Depending on the number of lesions, you may be able to remove them in a single setting or you may need follow up appointments.
Need more advice?
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