MOLLUSCUM CONTAGIOSUM
Molluscum Contagiosum is a common viral infection of the skin that appears as pink, round, umbilicated bumps. Molluscum are contagious and can spread from person-to-person contact as well as through contact with contaminated objects. Also, autoinoculation is possible when an infected person picks or scratches his/her own MC and thereby spreads lesions further over the body. Molluscum Contagiosum are commonly seen in infants and young children and less often in teenagers and adults. MC tend to be more numerous and more stubborn to treat in children who have eczema or atopic dermatitis due to changes in the skin barrier.
SYMPTOMS
Molluscum Contagiosum look like small, round pink or white papules with a central depression called an “umbilication.” They range in size from a pinpoint to the size of a pearl. Each papule contains a central white “ball” or sphere where the contagious viral particles are found. MC can be seen anywhere on the body (except the palms and soles) but tend to favor warm, moist areas such as armpits, groins or behind the knees.
TREATMENTS
There are numerous treatment modalities including physical destruction of the molluscum and topical medications. Some examples of physical destruction include: curettage to physically remove the infectious core, electrodessication and cryotherapy (liquid nitrogen). Some topical treatments are medications like Retin-A, salicylic acid, Imiquimod (an immune modulator) and Cantharidin (which is sometimes referred to as “beetle juice.”)
WARTS (VERRUCAE)
Warts are benign growths on the skin that are caused by an infection with the human papilloma virus (HPV). When the virus infects a cell in the skin, it causes rapid growth of skin cells that results in a wart. HPV is ubiquitous throughout our world. We come in contact with it by shaking hands or touching railings and door handles etc. However, some people are more prone to warts than others because those people have immune systems that are weaker at fighting off the virus. For example, children are more prone because their immune systems haven’t been exposed to HPV as much as adults have and consequently, they are not capable of mounting as strong an immune defense when exposed. Also, one is more likely to develop a wart when they have abraded, inflamed or cut skin. Therefore, people with eczema or who pick their cuticles are more likely to be infected with HPV.
SYMPTOMS
Warts present as soft or firm bumps on the skin that can range in color from white or skin-colored to pink or tan. They often have a rough surface with tiny pinpoint black dots on their surfaces. These black dots are actually thrombosed blood vessels. Warts are most commonly found on hands, feet and genitalia.
TREATMENTS
While 50-65% of warts, if left untreated, will resolve on their own within 1-2 years, most dermatologists recommend treating warts to decrease the likelihood of them spreading. Treatment can take weeks to months to be effective and warts can spread or recur. Salicylic acid is a convenient over-the-counter treatment. It comes in numerous preparations and concentrations and when used consistently a wart can resolve in roughly 3 months. Treatments that dermatologists use in the office include cryotherapy, chemotherapy, prescription medications, laser treatment or less often, electrodessication and curettage. In cryotherapy, liquid nitrogen is applied to the skin which causes a blister to form. When the blister breaks, the infected cells slough off. The chemotherapeutic agent, Bleomycin, can be injected into a wart and is another useful treatment. Immunotherapy is another common and efficient treatment option in which an antigen, such as Candida, is used to trigger an immune response from the patient’s body. Prescription medications such as imiquimod, 5-fluorouracil and tretinoin are also efficacious topical treatments. Certain lasers are very effective at destroying warts. Electrodessication and curettage involve burning the wart with a small needle (electrodessication) and then scraping it (curettage). This method is a last resort option as it can cause scarring and should never be used on the feet.
Dermatology
*This webpage is for informational purposes and is not intended to be, and should not be relied upon as, medical advice. Any medical concerns should be addressed with a physician.