In this article, we shall discuss molluscum contagiosum in a bit more detail.
Molluscum contagiosum is caused by a viral infection. The portal of entry of the riders 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 a lot more widespread. In children, the condition occurs due to sharing of towels and sponges. 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.
Typically, molluscum contagiosum results in the formation of multiple small papules with a waxy surface. They might be 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 coloured 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.
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 stains to help identify them under a microscope.
Most cases of molluscum contagiosum tend to resolve themselves in a few months. Molluscum contagiosum that affect the eyelids might be managed conservatively without performing any intervention. However frequently, a small amount of trauma to the lesion can help get rid of it. Another form of treatment is called curettage and involves administration of an anaesthetic agent followed by removal of the lesion completely.
Medical treatment is also available to manage molluscum contagiosum. However, 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) when compared to not offering the patient any treatment whatsoever.
Following the treatment, patients might 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.
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