Molluscum contagiosum is a rare viral infection that is exclusive to humans. It is characterized with the presence of small elevated lesions called papules. These papules have a waxy surface and are seen on various parts the body such as the face, trunk, arms and legs. It can also affect the armpits but does not involve the palms. It has also been found to affect the eyelids. Below we present more detail on molluscum contagiosum.
Cause of molluscum contagiosum
Molluscum contagiosum is caused by a viral infection. The portal of entry into the body is usually through some form of break in the skin. This occurs through direct skin to skin contact as well and can therefore be seen in individuals who share showers or athletes who share equipment in the gym. Having low levels of immunity such as in the case of HIV virus infections can also make an individual prone to developing molluscum contagiosum. In such individuals, the lesions are much more widespread. In children, the condition can occur due to sharing of towels and sponges among other items. Studies have also shown the development of molluscum contagiosum affecting the eyelids of both eyes following treatment of rheumatoid arthritis with specialist drugs such as methotrexate. Case studies have reported the eyelids being affected in children.
Clinical features of molluscum contagiosum
Typically, molluscum contagiosum results in the formation of multiple small papules with a waxy surface. They are usually clearly evident on the body especially on the eyelids. Typically, scratching the lesions can make them worse as more and more lesions form along the line of scratching. This is a typical phenomenon called as Koebner phenomenon.
Upon examination, the lesions are flesh colored and vary between 2 to 5 mm in size. Patients with poor immune levels tend to have multiple lesions all over the body. The involvement of the eyelids and the face is commonly seen in children whereas the involvement of the groin area is seen in adults. Associated with molluscum contagiosum are other skin conditions such as atopic dermatitis and eczema.
Diagnosis molluscum contagiosum
A diagnosis of molluscum contagiosum can be made by tests such as polymerase chain reaction and biopsy. A biopsy demonstrates the presence of specific structures within the lesions called inclusion bodies. These bodies can be stained using specific dyes to help identify them under a microscope.
Treatment molluscum contagiosum
Most cases of molluscum contagiosum tend to resolve themselves in a few months. Molluscum contagiosum that affect the eyelids could be managed conservatively without performing any intervention. However, a small amount of inflicted trauma to the lesion can help get rid of it faster. Another form of treatment is called curettage and involves administration of an anaesthetic agent followed by removal of the lesion completely. Although medical treatment is also available to manage molluscum contagiosum, detailed studies have shown that there does not appear to be any additional benefit of using these treatments (skin creams, anti-viral agents and herbal medicines) in comparison to not offering the patient any treatment at all. Following the treatment, patients could require follow-up appointments to see if the lesion is recurring.
Molluscum contagiosum is an uncommon problem that can affect various parts of the body. The involvement of the eyelids is more often seen in children and usually resolves by itself. Specific treatments can be offered though recurrence rates can be high.