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PATIENT STORY

An 8-year-old girl is brought to the office because of an outbreak of bumps on her face for the past 3 months (Figure 136-1). Occasionally she scratches them, but she is otherwise asymptomatic. The mother and child are unhappy with the appearance of the molluscum contagiosum and chose to try topical therapy. A topical treatment was chosen to avoid the risk of hypopigmentation that can occur in dark-skinned individuals with cryotherapy.

FIGURE 136-1

Molluscum contagiosum on the face of an 8-year-old girl. (Reproduced with permission from Richard P. Usatine, MD.)

An 11-year-old girl was also seen with molluscum on her face. The child and her mother decided to try cryotherapy as her treatment. She tolerated the treatment with liquid nitrogen in a Cryogun (Figure 136-2). The molluscum disappeared without scarring or hypopigmentation after 2 treatments.

FIGURE 136-2

Cryotherapy of molluscum on the face of an 11-year-old girl. The central umbilication is easily seen in the 2 papules that were just frozen. (Reproduced with permission from Richard P. Usatine, MD.)

INTRODUCTION

Molluscum contagiosum is a viral skin infection that produces pearly papules that often have a central umbilication. It is seen most commonly in children, but can also be transmitted sexually among adults.

EPIDEMIOLOGY

  • Molluscum contagiosum infection has been reported worldwide. An Australian seroepidemiology study found a seropositivity rate of 23%.1

  • Up to 5% of children in the United States have clinical evidence of molluscum contagiosum infection.2 It is a common, nonsexually transmitted condition in children (see Figures 136-1, 136-2, 136-3, 136-4).

  • The number of cases of molluscum in U.S. adults increased in the 1980s with the onset of the HIV/AIDS epidemic. Since the introduction of highly active antiretroviral therapy (HAART), the number of molluscum contagiosum cases in HIV/AIDS patients has decreased.3 However, the prevalence of molluscum contagiosum in patients who are HIV-positive may still be as high as 5% to 18% (Figures 136-5).4,5

FIGURE 136-3

A group of molluscum contagiosum lesions on the abdomen of a 4-year-old boy. (Reproduced with permission from Richard P. Usatine, MD.)

FIGURE 136-4

Molluscum contagiosum under the eye of a young girl with central umbilication. (Reproduced with permission from Richard P. Usatine, MD.)

FIGURE 136-5

Molluscum contagiosum on the face of a woman with HIV. Note the large molluscum on the scalp. (Reproduced with permission from Richard P. Usatine, ...

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