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Molluscum contagiosum in HIV infected. Molluscum contagiosum. Molluscum contagiosum treatment. What is Molluscum Contagiosum

Molluscum contagiosum is an infectious dermatovenerological disease that causes a benign skin lesion in the form of specific rashes. The causative agent is molluscum contagiosum, a virus of the Chordopoxvirus subfamily of the Poxviridae family. This microorganism belongs to the group of DNA-containing filtering proxiviruses and is similar in structure to the smallpox virus. Molluscum contagiosum virus is capable of reproducing exclusively inside a living cell, and only infects humans.

The disease is common in almost all countries of the world, and is diagnosed both in isolated cases and in the form of epidemics, which are most often observed in preschool institutions or sports teams where there is a high level of contact. According to statistics, the main contingent of patients with molluscum contagiosum is children under 10 years old and adults from 20 to 30 years old.

The virus enters the human body through microtrauma of the mucous or skin. The infection is transmitted by household and sexual contact: you can become infected with a mollusk when using hygiene items, bedding, in a bath, sauna or pool that are shared with the sick. In adults, infection most often occurs through direct contact with the patient's skin or sexual contact.

The development of molluscum contagiosum is facilitated by concomitant diseases that reduce the body's resistance. These can be immunodeficiency states caused by taking hormones, allergic diseases (in particular, atopic dermatitis), age-related disorders of the immune system. Skin rashes caused by Molluscum contagiosum virus are observed in 15-18% of HIV-infected patients.

In the international registry of diseases and pathologies of the ICD 10, the disease molluscum contagiosum has the code B08.1. Conscripts with such a diagnosis are assigned category G, and are given a deferment from service for six months or a year, after which they undergo a second medical commission. If during this period a complete cure has not occurred, the conscript is released from service.

Symptoms

In addition to rashes in the form of rounded papules (nodules) with an umbilical dent in the middle, characteristic only for this dermatological disease, the pathology has no symptoms. Nodules are painless, may be erythematous (swollen, inflamed), pearly white or the color of the surrounding skin. Inside the papule is a grayish-white mass, consisting of fat cells, remnants and waste products of the virus colony. When you click on the papule, the contents come out of it like an acne plug.

Usually, a few weeks after infection with a mollusk, from 1 to 20 nodules 2 ÷ 10 mm in size form on the body; with advanced disease, they can merge into conglomerates similar to cauliflower brushes. Large clusters of papules can cause slight itching, especially during their maturation. In patients with severely impaired immunity (congenital immunodeficiency syndrome, prolonged antibiotic therapy, HIV infection), papules can reach gigantic sizes, up to 3-4 cm. Large accumulations of papules can cause mild itching, especially during their maturation.

It is highly not recommended to open or squeeze out papules on your own - this can lead to infection of surrounding tissues with the molluscum contagiosum virus, and damaged skin will become a gateway for the penetration of other infections.

Localization of rashes can be different. In children, the rash most commonly occurs on the face, neck, shoulders, arms, abdomen, and back. In adults, which usually become infected during sexual contact - on the thighs, buttocks and external genitalia. Symptoms of the disease persist for several weeks or months, then in people with sufficiently strong immunity, the molluscum contagiosum gradually disappears. With a weak immune system, the disease can periodically recur for several years.

Diagnostics

In the presence of well-defined rashes typical of molluscum contagiosum - papules with depressed middle part and curdled contents, the diagnosis is not difficult. However, the dermatovenereologist often decides to conduct a differential diagnosis. The very presence of the molluscum contagiosum virus indicates a weakened immune system, which may be caused by the presence of other infections in the body.

Additional examinations are carried out to exclude the possibility of such pathologies as: pyoderma, acne, condylomas, lichen planus, keratoacanthoma, nevi, juvenile, annular or pyogenic granuloma, syphilitic papules, epithelioma, basal cell carcinoma.

Laboratory diagnosis of molluscum contagiosum is a histological examination of a scraping from the affected area of the epidermis. When it is studied under a microscope, special ovoid bodies (the so-called Henderson-Patterson bodies) are found. Such epithelial cells with cytoplasm inclusions are not detected in any other dermatovenereological diseases.

Treatment

If the molluscum contagiosum is not accompanied by discomfort and the degree of skin damage is small, most often the emphasis is on an independent radical remission, that is, on a complete recovery without using any treatment methods. In people with normal immunity, this disease usually goes away, gradually fading away, within six months. However, the molluscum contagiosum virus itself remains in the human body forever, because it has its own DNA, where its genetic code is stored.

Treatment of molluscum contagiosum is required:

in the presence of multiple foci of rashes, when the risk of secondary infection is high;
with a pronounced cosmetic defect;
in the absence of signs of extinction of the external manifestations of the disease;
in childhood when the immune system is still not strong enough, and the child can be a carrier of the infection for a long time;
during pregnancy (although this virus does not have a teratogenic effect on the fetus in the womb, the newborn can become infected from the mother, including through her milk).

The methods of treatment are determined by the doctor, mainly the removal of papules with virus-infected contents. The procedure can be carried out in one of the following ways:

Scraping of papules with a surgical spoon (curettage) or removal of their contents with tweezers, followed by treatment with antiseptic ointments or solutions, ultraviolet rays or low-frequency ultrasound.
Cauterization of rash nodules alternating current high frequency (diathermocoagulation);
Laser coagulation of mollusk papules;
Cryodestruction (treatment of mollusk formations with liquid nitrogen);
Destruction of papules by chemical agents.

In the disseminated form of the disease, when the rash covers large surface skin, children over 10 years of age and adults can be prescribed antibiotics (Oletetrin, tetracycline drugs, Doxycycline, Biseptol), antiviral drugs and immunomodulators (Isoprinosine, Interferon, Levamisole, Cytovir, Kagocel, Cycloferon).

An effective and painless method of treating molluscum contagiosum in children is the use of topical agents: point therapy with oil solutions of retinoids, an aqueous solution of cantharidin, the use of ointments with antiviral components cidofovir or imiquimod.

In the video, the doctor talks in detail about the methods of treating molluscum contagiosum in adults and children.

Many dermatologists strongly object to treating molluscum contagiosum at home. However, with a mild form of the disease, it is quite possible to use herbal remedies to combat it:

Spot burning. 3 times a day, lubricate the nodules of the mollusk with garlic or celandine juice, trying not to get it on healthy skin. A few days later, a small scab forms at the site of the papule, under which there will be young clean skin.
Treatment of the skin with a disinfectant decoction. The dry grass of the series is brewed with boiling water and insisted for several hours. The resulting solution is moistened with a gauze swab at the localization sites of the rashes. The course of treatment is optional.
Ointment for molluscum contagiosum. Peeled garlic cloves are thoroughly ground in a mortar and mixed with fresh butter in a ratio of 3:1. This ointment should be lubricated with each papule several times a day. After about a month, the nodules of the mollusk will disappear from the skin.

Prevention measures

Since the molluscum contagiosum virus is transmitted by household and sexual contact, a set of measures aimed at preventing the disease is based on the exclusion of contact with persons carrying the infection, as well as items for their personal use.

If a person is diagnosed with molluscum contagiosum, until complete recovery, he should avoid physical contact with the rest of his family and work team, use separate dishes, towels, bed linen. The bath after using it by the carrier of the infection should be treated with an antiseptic solution. A carrier of the virus is not allowed to visit a public pool or bathhouse.

Hygiene of sexual intercourse also belongs to the main preventive measures. If the molluscum contagiosum virus is detected in a patient, it is recommended to conduct an examination of his sexual partners.

- a chronic highly contagious skin disease, the causative agent of molluscum contagiosum is included in the smallpox group of viruses - Molluscipoxvirus. According to the international classification of diseases, molluscum contagiosum does not belong to sexually transmitted diseases, however, WHO includes molluscum contagiosum in the list of sexually transmitted infections. Persons of both sexes are susceptible to infection, regardless of age groups, but people who are promiscuous in sexual contact and children are at risk.

Molluscum contagiosum pathogenesis

Molluscum contagiosum is a benign neoplasm of the skin; DNA virus synthesis occurs in the keratinocytes of the epidermis, after the virus multiplies in the host cells, the activity of T-lymphocytes is blocked, and therefore there are no immune cells during the lesion, which explains the immune tolerance that favors the pathogen during infection.

Ways of infection and pathogenesis of molluscum contagiosum

Molluscum contagiosum is a disease that affects only humans. Infection occurs through direct contact of a sick person with a healthy person, but there is an indirect way of infection - through contaminated objects.

Adults are mainly infected with molluscum contagiosum through sexual contact, infection occurs due to skin contact of partners, and not through coitus, which is why some international medical organizations do not classify molluscum contagiosum as a group of sexually transmitted infections. The affected area during sexual intercourse is usually the perineum, inner thighs, lower abdomen, external genitalia.

When infected by the domestic route, there is no definite localization of molluscum contagiosum; neoplasms can be found on any part of the skin. The presence of damage and microtrauma of the skin is a favorable condition for the inoculation of the virus. Cases of infection are usually isolated, despite the high contagiousness of the mollusk, but in kindergartens, lesions can be endemic.

Factors such as crowding, skin contact, and a humid atmosphere favor dissemination. The incubation period of molluscum contagiosum is from several weeks to several months, so it can be difficult to determine the source of infection. After the appearance of clinical manifestations, molluscum contagiosum spreads throughout the body by self-infection. Cellular immune deficiencies, congenital and acquired, contribute to infection; in people with HIV infection, the incidence of molluscum contagiosum is several times higher.

Since the causative agent of molluscum contagiosum is a DNA virus, it is impossible to achieve a complete cure, however, modern methods of exposure make it possible to achieve a long and stable remission.

Clinical manifestations of molluscum contagiosum

After the incubation period, single, painless, dense rounded nodules appear on the skin, the color of the skin affected by molluscum contagiosum is usually unchanged or acquires a pink tint, sometimes a waxy or pearly sheen may be noted. Further, there is an increase in the number of elements of molluscum contagiosum due to self-infection. The size of the rashes is from millet grain to a pea, sometimes when the elements merge, giant contagious molluscs can form, they look like hemispherical papules with a sunken central part.

The nodules are located everywhere on the body, but since at the second stage of development of the molluscum contagiosum self-infection occurs through the hands, the skin areas that are most often touched are affected. This is the face, neck, upper body and actually the hands themselves. Rashes of molluscum contagiosum are erratic, and their number sometimes reaches several hundred, rubbing of the hands and involuntary scratching increase the number of disseminations.

When pressed with tweezers or accidentally damaged molluscum contagiosum, a white mushy mass is released from it, which consists of keratinized cells and lymphocytes. But it also contains inclusions of mollusc-like bodies, thanks to which the disease got its name. There are no subjective sensations, but some patients with molluscum contagiosum note itching and slight infiltration, which occurs when a secondary infection is attached.

With atypical forms of molluscum contagiosum, there may be no characteristic concave center on the rash, and the elements themselves can be very small. Profuse forms of molluscum contagiosum are diagnosed in children with atopic dermatitis, in children with leukemia and immunodeficiencies, as well as in HIV-positive patients. As a rule, the course of molluscum contagiosum passes without complications, aseptic and purulent abscesses of the skin around the affected area are possible. In very rare cases, superinfection is observed, after which scars remain.

Diagnosis of molluscum contagiosum

Molluscum contagiosum treatment

Surgical removal using curettage after preliminary local anesthesia under the film gives a good effect, since a large number of molluscum contagiosum can be removed in one session due to the almost complete absence of pain during the procedure. Usually one session per month is carried out, and in a few months there is a complete clinical recovery. With this method of treatment, the contents of the nodules do not remain, the traumatization of the skin is minimal, after curettage, in some cases, electrocoagulation of the lesions is indicated.

Removal of skin formations of molluscum contagiosum is possible by cryodestruction or radio wave method. Laser removal is also used. If there are few rashes of molluscum contagiosum, then chemotherapy drugs give a good effect, but it is not recommended to use them for a long time because of the irritating effect on the skin. For mild dissemination, therapeutic ultraviolet irradiation of the affected skin and the use of acyclovir creams are indicated for all patients with molluscum contagiosum.

The method of applying Tuberculin to the area affected by molluscum contagiosum is especially often used in pediatric dermatology, as it is painless. This technique is new, and therefore there are no exact statistics on its effectiveness. But children should be pre-vaccinated with BCG or isoprinosine.

Prevention and prognosis

In most cases, the prognosis for infection with molluscum contagiosum is favorable, the exceptions are patients with immunodeficiency states. Prevention consists in maintaining personal hygiene both in public places and at home. It is necessary that each family member has his own washcloth and other bath accessories. When diagnosing molluscum contagiosum in children, infected children are isolated and quarantined for the duration of the incubation period with a daily preventive examination of the entire children's team and attendants.

Contagious, or contagious, mollusk(syn.: molluscum epitheliale, epithelioma contagiosum) - viral dermatosis, observed more often in children. The disease is caused by the molluscum contagiosum virus, which is a member of the poxvirus family. Two types of virus are known. However, to date, it has not been possible to isolate the virus in cell culture. Under electron microscopy, it is indistinguishable from other poxviruses. More often (at 16-91°C) the causative agent of the disease is the molluscum contagiosum virus type 1; in HIV-infected people, as a rule, it causes the molluscum contagiosum virus type 2. At the same time, the morphological manifestations of the disease in both types of virus are the same.

Molluscum contagiosum infection occurs with direct contact (in adults, often with sexual contact), or indirectly, when using common hygiene items (washcloths, sponges, towels, etc.). Epidemic outbreaks of the disease are possible in children's groups. The incubation period varies from 2 weeks. up to 6 months In middle-aged and elderly patients, long-term treatment with corticosteroids and cytostatics may be a provoking factor predisposing to a-disease.

At the site of inoculation molluscum contagiosum virus there are smooth, shiny, as if translucent, pink or gray-yellow, well-defined domed, round or oval nodules with a diameter of 1-2 mm to 10 mm. Nodules can reach their maximum size in 6-12 months. the course of the disease. The presence of an umbilical-visible depression in the center is characteristic. The number of elements can be different - from single, located more often on the face, neck, chest, flexion surfaces of the limbs, back of the hands, to numerous, randomly scattered throughout the skin or grouped into separate foci. Sometimes molluscum contagiosum occurs in places of skin trauma (Kebner pseudophenomenon). With the sexual route of infection, rashes can be localized on the pubis, genitals, inner surface hips. There are no subjective sensations. Sometimes the rashes merge into large uneven tumor-like formations ("giant clam"). Characteristic of nodules of molluscum contagiosum is the release of a whitish mushy mass from the central recess of the papules when they are pushed with tweezers.

The course of molluscum contagiosum. In patients with normal immunity without treatment, the disease lasts for several months or more, and some elements may spontaneously disappear (especially after suppuration), others occur in previously unaffected areas as a result of autoinoculation. including on contact surfaces of the body (for example, in the armpits). After 6-9 months, less often - after 3-4 years, the molluscum contagiosum regresses spontaneously. The solitary focus can persist for up to 5 years. Spontaneous involution is accompanied by the expression of specific serum antiviral antibodies. In HIV-infected people, molluscum contagiosum is more severe and manifests itself as hundreds of small or “giant” elements on the face that disfigure the patient, the disease often spreads during shaving and steadily progresses without treatment, leading to cosmetic defects (especially on the face).

Histologically, the formation of molluscum contagiosum consists of "inverted" lobules of squamous epithelium, expanding in the underlying dermis. The cells that form these lobules have characteristic cytoplasmic inclusions - mollusk bodies that contain poxvirus DNA. These inclusions are initially eosinophilic. appear in cells located above the basal layer, then their number and size progressively increase as the layers grow. In the upper layers, they become basophilic, occupying the entire cytoplasm of cells, pushing the nucleus to the periphery. As a result, mollusk bodies, together with keratohyalin masses, are forced out into the pentra of the lesion, filling the crater-shaped depression. A moderate inflammatory infiltration is found in the surrounding dermis.

Diagnosis of molluscum contagiosum established on the basis of the clinical picture. If necessary, a microscopic examination is carried out (a smear is prepared from a detachable horny mass; when stained by Gram, intracellular cytoplasmic inclusions - mollusk bodies are visible) or identification of virus DNA using a polymerase chain reaction. In HIV infection, a biopsy is indicated to exclude deep mycoses.

Differential diagnosis of molluscum contagiosum with multiple elements, it is carried out with milia, vulgar warts, genital warts, syringoma, hyperplasia of the sebaceous glands; with a solitary focus - with kerato-acanthoma, hydrocystoma, pyogenic granuloma, squamous cell skin cancer, basalioma. With HIV infection - with cryptococcus. histoplasmosis. coccidioidomycosis penicillinosis.

Molluscum contagiosum treatment: squeezing out nodules with tweezers or scraping with a Volkmann spoon, followed by treatment with a 2% alcohol solution of iodine. Diathermocoagulation of elements, application of aromatic retinoids or podophyllotoxin are also used. In disseminated forms of the disease, antiviral agents are recommended: metisazon 0.1-0.6 g, depending on age, 2 times a day for 7 days; interferon a 3-4 drops in the nose 4-5 times a day. Cryodestruction is effective, but requires repeated sessions with an interval of 3-4 weeks.

Molluscum contagiosum prevention is to avoid contact with patients. A child diagnosed with molluscum contagiosum is isolated from the children's team until complete recovery. For healthy children who have been in contact with the patient, for prophylactic purposes, interferon is recommended to be instilled into the nose, 1-2 drops 3 times a day. HIV-infected people with facial rashes are advised to shave less often and grow a beard.

molluscum contagiosum is a viral skin disease affecting only the upper layers of the skin. Its occurrence in the population is quite high due to the fact that the virus is transmitted by household means. Large concentrations of the pathogen are found in children's sandboxes, which is why it is children of preschool and primary school age that make up the bulk of patients with this virus. Adults of all ages are also affected, and the transmission path in them becomes mixed - contact-household and sexual. The incubation period of the disease ranges from 15 days to 3 months. There are cases of the disease after 6 months from the moment of infection.

Diagnosis of the disease in most cases is not difficult and is based only on the appearance of skin lesions. In patients with a good state of immunity, the clinical course of molluscum contagiosum is usually mild with spontaneous disappearance of elements after 4 to 6 months. A protracted and chronic course of the disease is observed when infection of skin formations or ulcers left after their opening. Elderly patients are also susceptible to chronic course due to a decrease in the viability of their immunity.

Treatment of molluscum contagiosum is medical and surgical. The combination of these methods leads to the best result. Traditional medicines are also used, and often their effectiveness is not inferior to traditional medicines.

Prevention of this disease is primary and secondary. Primary prevention is aimed at preventing infection, and secondary prevention is aimed at preventing chronicity. inflammatory process.

Skin anatomy

Knowledge of skin anatomy is necessary to understand the mechanism of infection by the molluscum contagiosum virus and its further development.

The skin is the largest organ human body. It consists of three main layers - the epidermis ( surface), dermis ( intermediate) and subcutaneous adipose tissue ( deep layer).

The epidermis, in turn, also consists of several layers. Its main part consists of four layers - basal, spiny, granular and superficial horny. On the palms and feet, the skin thickens due to the shiny layer located between the granular and stratum corneum. In the eyelid area, there is the thinnest skin, consisting of only three layers ( no granular and shiny layer). In addition to the cells of the above layers, the skin contains numerous pigment cells, macrophages ( immune cells that provide non-specific defense of the body) and nerve endings. There are no blood vessels in the epidermis, so cells are nourished by the transport of amino acids, glucose, fatty acids from the interstitial fluid through the cell wall.

The dermis consists of two layers - papillary ( superficial) and mesh ( deep). The papillary layer consists of loose unformed connective tissue, which protrudes into the epithelium in the form of papillae, increasing the contact area between the layers. This feature helps prevent intradermal ruptures during its strong stretching, as well as improve the delivery of nutrients to the epidermis. Each papilla contains its own arteriole, which branches abundantly into many capillaries. Near the arteriole there is one or two venules that collect blood, rich in products decay and carbon dioxide. At the base of the papillary layer are close arterial and venous networks, which, through larger vessels, communicate with the rest of the bloodstream.

The reticular layer of the dermis is located deeper than the papillary and is its mechanical support, since it consists of dense, unformed connective tissue. The space between the connective tissue fibers is filled with an amorphous substance, which gives strength to the entire structure.

The subcutaneous adipose tissue or hypodermis consists predominantly of adipose tissue organized into lobules. It contains a small number of blood vessels and is quite mobile. Its main functions are thermoregulation, prevention of mechanical damage. internal organs and energy depot.

The causative agent of molluscum contagiosum

Molluscum contagiosum is caused by the molluscum contagiosum virus from the poxvirus family. There are 4 types of this virus - MSV-1, MSV-2, MSV-3, MSV-4. The most common strain is MCV-1. The MCV-2 strain is more characterized by sexual transmission, as well as transmission through water reservoirs during bathing. This pathogen is dangerous only for humans, that is, animals cannot get sick with it, but they can be carriers.

The penetration of the virus into the skin occurs by direct contact with it, and this process takes some time. Timely treatment with antiseptics or simply washing it often prevents infection. However, if the virus has entered the thickness of the epidermis, then it multiplies in the epithelial cells of its basal and granular layer. As it reproduces, it fills the internal space of the host cell, spending its energy and plastic resources on its own reproduction. When these resources run out or all the free space of the host cell is filled, the virus destroys it from the inside, getting into the intercellular space and infecting the surrounding healthy cells.

Thus, as the number of viral bodies increases, the focus of the disease grows. Destroyed cells accumulate inside the focus in the form of a curdled or white waxy mass. If this focus is not injured, then the virus does not go beyond it. A few weeks after infection, specific immunity against the molluscum contagiosum virus is developed, which gradually destroys the focus ( foci), resulting in complete recovery. Unfortunately, immunity to this pathogen is unstable, so cases of re-infection some time after the cure are quite common.

If the virus goes beyond the focus and spreads to surrounding healthy tissues, then after a while it will cause the appearance of new foci in neighboring areas of the skin.

Also, if the virus does not meet with adequate resistance from the immune system, the rate of its reproduction increases significantly. At the same time, the sizes of the foci themselves increase. The larger the focus, the thinner its wall and, accordingly, the higher the risk of its rupture and spontaneous spread of the virus to surrounding tissues and objects.

Molluscum contagiosum symptoms

The symptoms of molluscum contagiosum are quite recognizable. Foci of infection are initially small papules ( 2 - 4 mm), hemispherical, flesh-colored, somewhat elevated above the surface of the skin. They may be somewhat shiny or more pink than the surrounding tissue. Sometimes they grow a thin leg. As the foci grow, they reach sizes up to 1 cm in diameter and acquire a distinctive feature - a slight depression in the center. Through this hole, when pressed, a whitish curdled mass is released. In some cases, the foci merge, forming conglomerates up to 2–3 cm in diameter. Usually on the body there are from 1 - 2 to 10 skin lesions.

From the appearance to the maturation of the focus of molluscum contagiosum, an average of 2-4 weeks passes. During this time, the patient experiences absolutely no inconvenience except for a cosmetic defect. The attachment of a bacterial infection to the focus of the mollusk leads to a more pronounced inflammatory process, which may cause mild or moderate itching. Pain is usually absent.

The above description of molluscum contagiosum lesions is a classic. However, there are also atypical variants of the course of this disease.

Atypical forms of molluscum contagiosum

Atypical form of molluscum contagiosum	Description
*Giant*	The sizes of the foci reach a diameter of more than 2 centimeters. This form is a consequence of the merging of several foci into one pathological process.
*keratinizing*	The surface of the foci with this form is not solid and smooth, but whitish. It is observed with concomitant skin diseases, extremely pronounced dry skin.
*cystic*	The focus in the cystic form of the usual or slightly enlarged size, but without a characteristic umbilical depression in the center.
*ulcerated*	This form of molluscum contagiosum develops when a secondary bacterial infection attaches to the ulcer left after opening the focus. It is characterized by longer healing with more massive scars.
*Miliary*	The miliary form is characterized by many adjacent small foci of molluscum contagiosum.

What does a molluscum contagiosum lesion look like in different areas of the skin?

Theoretically, the molluscum contagiosum virus can infect absolutely any area of the skin. However, in practice, there are areas of the most frequent localization of cutaneous elements, which most likely depend on the method and conditions of infection.

Eyelid infection with molluscum contagiosum

The defeat of the eyelids with molluscum contagiosum is observed mainly in children and in adults up to 20-25 years old. The form of the disease in this case is often miliary, due to the small thickness of the epidermis. The mechanism of contact-household infection is through dirty hands.

On the upper and lower eyelids, numerous foci are observed, not exceeding 2–3 mm in size with a characteristic depression in the center. Very rarely, these foci are located on the leg.

Skin lesions with molluscum contagiosum

Facial skin is one of the most common sites of molluscum contagiosum in children. The mechanism of infection is contact-household in case of non-compliance with the rules of personal hygiene. The shape of the foci is mostly typical.

Damage to the décolleté and armpits with molluscum contagiosum

The décolleté and armpits are affected by molluscum contagiosum primarily or secondarily when the virus spreads from the skin of the face. The mechanism of infection in both cases is contact-household. The shape of the foci is typical. There is an ulcerated form in women due to trauma to the foci with a bra and infection in them. In total, the number of foci can reach 8-10 due to the high probability of the pathogen spreading when the lesion shell is damaged. Skin elements are often located in a group, sometimes merge into a single pathological process, leading to the appearance of giant foci.

Molluscum contagiosum lesions of the skin of the abdomen, perineum and genitals

This localization is characteristic mainly for contact-sexual infection with molluscum contagiosum. If sexual intercourse was carried out using a barrier method of contraception ( condom), then the skin of the penis and the mucous membrane of the vagina may remain unaffected by the virus. Otherwise, the virus can spread to them. However, the presence of a condom does not prevent skin-to-skin transmission of the virus, so during sexual transmission, molluscum contagiosum can occur in the vulva, perianal region, buttocks, thighs, and abdomen. Due to constant friction and high humidity, the skin elements in these areas are easily injured and infected. It also leads to the rapid spread of the pathogen to other parts of the body.

Molluscum contagiosum lesions on the hands and feet

Molluscum contagiosum affects the skin of the feet, hands, as well as fingers and toes occurs primarily with contact-household infection or secondarily with the spread of infection from the genital area, where the virus got through sexual contact. In fairness, it should be noted that the reverse sequence also occurs, in which the occurrence of foci of infection in the groin occurs after the introduction of the molluscum contagiosum virus from the skin of the hands.

The shape of the skin elements of molluscum contagiosum in these localizations, as a rule, is typical. Sometimes there are foci that resemble warts in shape with severe hyperkeratosis.

Diagnosis of molluscum contagiosum

Diagnosis of molluscum contagiosum usually does not cause difficulties, due to the rather characteristic appearance skin elements. However, some forms of molluscum contagiosum can be difficult to distinguish from flat warts or acne. Giant foci of molluscum contagiosum can be outwardly confused with keratoacanthoma ( benign epithelial tumor). Small lesions are sometimes difficult to distinguish from milia ( white spots, prosyanka, miliary cysts).

To clarify the diagnosis, the alleged formation is compressed from the sides. If a curd mass is released from its top, then in 99% of cases this indicates in favor of a molluscum contagiosum. If there is no discharge, then the top of the focus should be carefully opened with a sterile scalpel or the tip of a needle. For a more accurate diagnosis, the released mass should be examined under a microscope. If the smear shows degenerative epithelial cells with large inclusions ( Lipschutz bodies) in their cytoplasm ( liquid part of a cell that surrounds its nucleus), then such a picture testifies in favor of molluscum contagiosum. If the smear contains predominantly immune cells or other contents, then the diagnosis is most likely to be another disease ( acne vulgaris, specific granulomas, warts, etc.).

Another method for diagnosing molluscum contagiosum is PCR ( polymerase chain reaction) with markers corresponding to this pathogen. The investigated substrate in this case is the contents of the hearth. This method is extremely accurate and allows you to finally establish the cause of the disease, but it is used quite rarely, only in controversial cases due to the relatively high cost.

If the diagnosis of molluscum contagiosum is excluded, then another reason for the appearance of a cutaneous formation should be sought. To achieve this goal, the most reliable method is a histological examination, in which part or all of the formation is removed at once, after which it is frozen, treated with special reagents and cut into the thinnest way. Then each section is stained with different dyes to more clearly identify certain tissues. Then, according to the structure of the tissues and the shape of the cells of the skin formation, the pathologist establishes the final diagnosis.

Where do molluscum contagiosum lesions appear?

Theoretically, molluscum contagiosum can appear on any part of the skin and mucous membranes, however, as a rule, the foci of this disease are grouped according to the route of infection.

Manifestations of molluscum contagiosum in the contact household route of infection

With a contact household route of infection, molluscum contagiosum is located mainly on the hands, face and upper half of the body. The number of elements can reach 10, but usually there are no more than 4 - 5. Sometimes lesions appear on the mucous membrane of the eyelids, nose and mouth, as well as on the skin of the eyelids. The causative agent enters the mucous membranes if the rules of personal hygiene are not followed.

Manifestations of molluscum contagiosum during sexual transmission

With the sexual route of infection, the rashes are located mainly on the genitals and tissues adjacent to them. Thus, with unprotected sexual contact in men, rashes can be on the body and head of the penis, on the testicles, on the skin of the pubis, femoral folds, in the perineum and even in the gluteal folds. In some cases, rashes spread to the lower part of the body mainly along the front surface. If a condom was used during intercourse, then the likelihood of foci of molluscum contagiosum on the penis is low, but the surrounding tissues are affected to the same extent.

With sexual infection of women with molluscum contagiosum, the pattern of appearance of rashes is the same as in men. During unprotected intercourse, the mucous membrane of the vagina, cervix, epithelium of the small and large labia, perineum, pubis, femoral and gluteal folds are affected. With unconventional sexual intercourse, foci of molluscum contagiosum may appear on the mucous membrane of the rectum and perianal region, as well as in the oral cavity. Accordingly, the use of a condom significantly reduces the risk of damage to the mucous membranes.

Mixed localization of rashes of molluscum contagiosum

In practice, there are often cases of scattered localization of rashes, when they occur evenly throughout the body. Most often this is due to spontaneous opening of the foci or their intentional opening without observing the rules of asepsis. The fact is that the contents of the skin elements of the molluscum contagiosum are extremely contagious. It is enough for him to get on neighboring healthy skin areas, even in negligible concentrations, and after a while new foci will appear on them.

It is also worth noting that in a healthy body, rashes of molluscum contagiosum, if not disturbed, disappear on their own after 4 to 6 months. After their disappearance, temporary immunity arises for several years. After this period or when the immune system is weakened, the likelihood of a recurrence of the disease increases again. However, if immunity is initially reduced, such as with HIV, chronic stress, or after prolonged systemic use of glucocorticosteroids, the disease may proceed more aggressively. The number of rashes increases from 4 - 5 to 10 - 20 or more. Instead of foci regular size confluent giant lesions occur, which often become infected and cause soreness with itching. New foci appear quickly, while old foci are practically not cured due to the fact that immunity to the pathogen is not developed or is insufficient.

Is molluscum contagiosum treated with medication?

Molluscum contagiosum is treated with medication. However, it should be noted that such treatment is incomplete. The correct approach to the treatment of this disease is the surgical opening of the focus, followed by its sanitation with antiseptic agents. It is not recommended to carry out such treatment on your own, due to the risks of accidental spread of infection to healthy tissues. In order to avoid such a complication, for the treatment of molluscum contagiosum, you should contact a specialist, that is, a dermatologist.

However, if for some reason it is not possible to seek qualified help, then treatment can only be carried out with the use of medications. Treatment of molluscum contagiosum is carried out only with local dosage forms, that is, ointments, creams, solutions and infusions. The systemic use of drugs in uncomplicated forms of the disease is not justified, due to the fact that the virus is found only in the epithelium and is absent in the blood.

Among the most common groups of drugs for the treatment of manifestations of molluscum contagiosum, antiviral drugs are distinguished, as well as disinfectants and antiseptics. In addition to the above-mentioned drugs, drugs from other groups are also used, but their effectiveness is usually not high, and they are prescribed exclusively in combination with the main groups.

Treatment of molluscum contagiosum with antiviral drugs

Treatment of manifestations of molluscum contagiosum is subject to certain principles. Their use should be exclusively local. Systemic use only makes sense in seriously immunocompromised patients. Preparations are selected, the concentration of active substances in which is maximum, in order to penetrate into the deeper layers of the skin, if the foci are located on the skin of the trunk, limbs and face. For the treatment of lesions that appear on the mucous membranes, the usual concentrations of the active substance are selected.

For the treatment of manifestations of molluscum contagiosum on the skin of the trunk, limbs and face, the following antiviral drugs are used:

cream / ointment acyclovir 5%;
tebrofen ointment 5%;
oxolinic ointment 3%;
ointment Viferon 40000 IU/g, etc.

For the treatment of manifestations of molluscum contagiosum on the skin and mucous membranes of the eyelids, oral cavity and genital organs, the following antiviral drugs are used:

eye ointment acyclovir 3%;
tebrofen ointment 0.5% ( ophthalmic) and 2% ( for other mucous membranes).

To achieve a therapeutic effect, it is necessary to apply the above ointments or creams on the affected surfaces with a thin layer 2 to 4 times a day for at least 2 to 3 weeks. Rubbing medicines is prohibited in order to avoid violating the integrity of the focus and spreading the infection to healthy areas of the skin.

It should also be noted that parallel treatment with antiviral drugs, local disinfectants and antiseptics is allowed. First, disinfectants and antiseptics are applied, and after they dry, antiviral agents are applied.

Treatment of molluscum contagiosum with disinfectants and antiseptics

Disinfectants and antiseptics are also actively used in the treatment of molluscum contagiosum. Their effect is predominantly superficial, and therefore the treatment is not aimed at destroying the focus, but at preventing complications and the spread of infection to healthy tissues, while the immune system will destroy it on its own. Preparations of this group are used mainly on the skin, but not on the mucous membranes.

The following disinfectants and antiseptics are used to treat the manifestations of molluscum contagiosum:

ointment betadine 10%;
alcohol solution of iodine 2%, 5%;
alcohol solution of brilliant green 1%, 2% ( brilliant green);
methylene blue aqueous solution 1% ( blue);
fucorcin;
alcoholic solution of boric acid 3%;
lapis pencil with silver nitrate, etc.

These drugs are used exclusively locally 3-4 times a day throughout the entire time, until the focus of molluscum contagiosum is completely healed. In this way, drug treatment disinfectants and antiseptics without deliberately opening the skin elements can last for months.

Preference is given to thick dosage forms ( ointments and creams) due to a longer effect, however, if they are not available, then solutions are also successfully used ( water and alcohol). For children, aqueous solutions are chosen, due to less pain when applied to the skin. Ethyl alcohol has absolutely no effect on the molluscum contagiosum virus, however, it dries out the skin over the source of infection.

Almost all preparations of this group are easily combined and replaced by each other, with the exception of a lapis pencil containing silver nitrate. Upon contact with other disinfectants and antiseptics, their mutual decomposition occurs, and the therapeutic effect disappears.

Other medicines for treating molluscum contagiosum

Other medicines for the treatment of molluscum contagiosum include antibacterials, immunomodulators, dermatotropic agents, and, if necessary, symptomatic treatments ( antipruritics).

Among the drugs from various groups for the treatment of molluscum contagiosum include:

levomekol;
sinaflan;
isoprinosine;
allomedin;
zinerite, etc.

Levomekol
Levomekol is a combination drug, which includes the antibiotic - chloramphenicol ( chloramphenicol) and an antimicrobial agent - methyluracil. After application to the wound surface, the drug has a bactericidal and anti-inflammatory effect, and also promotes tissue healing processes. Accordingly, the drug is prescribed mainly for the treatment of a bacterial infection that has joined the foci of molluscum contagiosum. In case of infection of foci in the conjunctiva of the eyelids, tetracycline ointment is prescribed.

Sinaflan
This drug belongs to the group of local glucocorticosteroids, and therefore its effect is a pronounced anti-inflammatory and anti-allergic effect. However, when a bacterial infection is attached, this drug should not be prescribed due to the high risk of spreading the infection. In the absence of sinaflan, it can be replaced with analogues according to the effect produced ( prednisolone ointment, diprosalic, etc.).

Isoprinosine
Isoprinosine is a representative of immunostimulants - drugs that enhance the body's nonspecific resistance to foreign infectious agents. Thus, this drug eliminates the main condition that contributes to the occurrence of manifestations of molluscum contagiosum - weak immunity.

Allomedin
Allomedin is a drug belonging to the group of dermatotropic drugs that have a broad antiviral and anti-inflammatory effect. It can be applied both to intact lesions and to the bottom of the ulcer left after surgical removal of lesions.

Zenerite
Zineryt is a combined preparation consisting of an antibiotic - erythromycin and zinc acetate. This drug is positioned as an effective anti-acne agent, but it has also been successfully used for manifestations of mild to moderate molluscum contagiosum.

How are manifestations of molluscum contagiosum removed?

To date, there are traditional and modern methods for removing the manifestations of molluscum contagiosum. The use of any of these methods requires compliance with numerous rules, and therefore, to perform this procedure, it is recommended to contact a specialist - a dermatologist.

The traditional method of removing manifestations of molluscum contagiosum

With the traditional method of removing the manifestations of molluscum contagiosum, first of all, the focus and the skin area around it are treated with antiseptic agents. Usually, 96% alcohol and betadine or 5% alcohol solution of iodine are used for this purpose. Then, using anatomical tweezers ( with straight and parallel jaws) the focus is gently squeezed from the sides until the curd mass is released from the umbilical depression on its surface. If, with moderate compression, the release of these masses does not occur, then the top of the focus is carefully cut off with a sterile scalpel or the tip of an injection needle. Anesthesia in this case is not carried out, since the procedure is almost painless. After this manipulation, the release of white mass from the focus will occur with the slightest pressure on it.

The next step is the complete cleaning of the hearth from curdled secretions. First stands out maximum amount thick secret when pressing on the focus from the sides. When the discharge stops, the remains of necrotic masses are taken from the bottom of the resulting sore using a small curette. Also, with its help, a small amount of healthy tissue is scraped off from the bottom of the focus in order to remove parietal cells affected by the virus.

The final stage is the introduction of antiseptic solutions into the sore, which remains after the opening of the focus. Most often, an alcoholic or aqueous solution of iodine is used, however, with no less efficiency, brilliant green, methylene blue or fukortsin can be used. Sores should be treated with these solutions twice a day for the first 5-7 days, and then once a day until the wounds are completely healed.

This method is clearly more effective than treating the manifestations of molluscum contagiosum with drugs alone, since it leads to a cure much faster. With its use, after 2-3 weeks, all traces of the disease will disappear, while with a strictly medical approach, treatment is delayed for months. However, it is not without drawbacks. The most significant of these is the relatively high likelihood of scarring at the site of former lesions. The larger the focus, the higher the likelihood of scar formation and its size. Also, the size of the scar increases with the addition of a bacterial infection during treatment.

Modern methods of removing manifestations of molluscum contagiosum

The main difference between modern methods of removing molluscum contagiosum from the traditional method is a lower degree of tissue injury and, as a result, a lower likelihood of scarring. In other words, science in this case pursues cosmetic goals.

Modern methods of removing manifestations of molluscum contagiosum include:

laser therapy;
electrocoagulation;
cryotherapy;
ultrasound therapy.

Laser therapy ( laser removal)

Removal of manifestations of molluscum contagiosum with a laser is carried out by directing a beam of photons of a certain wavelength to the focus of infection. The width of the beam can reach tenths of a millimeter, which definitely has a positive effect on the cosmetic aspect of the operation. In addition, upon contact with the laser, the tissues of the focus are instantly cauterized, and therefore the risks of bleeding are reduced. Under the influence high temperatures kills most of the virions structural unit of molluscum contagiosum virus), while reducing the likelihood of accidental spread of infection to surrounding healthy tissue.

Another advantage of this method of removing molluscum contagiosum is almost complete painlessness, so this method is recommended for children. Since the method is non-contact, the risks of infection with concomitant infections ( hepatitis viruses, HIV, etc.) are almost zero due to insufficient processing of the instrumentation.

Electrocoagulation

Today, this method is actively used in most clinics in routine surgical practice. With the help of a special electric scalpel with various nozzles, cauterization of the necessary tissues is carried out. The advantages of this method are bloodlessness and deeper destruction of the infectious agent right in the focus with minimal risks of its spread. In addition, the healing of postoperative wounds is faster and the likelihood of scarring is reduced.

Cryotherapy

Cryotherapy refers to the removal of manifestations of molluscum contagiosum with liquid nitrogen. The procedure itself is painless and lasts, as a rule, no more than 10 - 15 minutes. However, a few hours after it, aseptic inflammation develops at the site of its conduction, which is the more pronounced, the wider and deeper the effect of the cold. Pain is the stronger, the more pronounced the inflammatory process. In connection with the above features, this method of removing foci of molluscum contagiosum is not recommended for use on children.

The advantage of this method is its non-contact, and, consequently, low chances of infection with hepatitis B and C viruses, HIV, etc.

Ultrasound Therapy

Ultrasound therapy, or rather the use of an ultrasonic knife to remove manifestations of molluscum contagiosum, is one of the most modern methods in dermatology and surgery in general. With the help of an apparatus called "surgitron" it is possible to generate concentrated ultrasonic radiation, which makes it possible to dissect tissues extremely accurately. The width of the cut with this tool reaches several microns ( one thousandth of a millimeter), so the ultrasonic knife is mainly used to achieve a good cosmetic effect of operations. The thinner the incision, the sooner healing occurs and the less scar tissue is formed.

Prevention of manifestations of molluscum contagiosum

Prevention of manifestations of molluscum contagiosum is divided into primary and secondary. Primary prevention is aimed at preventing infection with this virus, and secondary prevention is aimed at preventing the spread of the infection and its protracted course.

Primary prevention of manifestations of molluscum contagiosum

The first rule of prevention of infection with the molluscum contagiosum virus is personal hygiene. In the domestic way of infection, it is necessary to wash your hands with soap and water after contact with the ground and especially sand from children's sandboxes, since it is in sandboxes of mass use that high concentrations of this pathogen are noted. To prevent the disease in children, it is recommended to let them play in their own sandboxes built by themselves, in which only healthy children play. If this is not possible, then it is recommended to call the child to you as often as possible and thoroughly wipe your hands with wipes containing antiseptic agents. You also need to wean the child from touching himself with dirty hands, in particular, the face, neck and upper body. You should also swim in proven reservoirs, and preferably in pools. Sea water, unfortunately, also does not do any harm to the molluscum contagiosum virus.

Prevention of a sexual way of infection is more difficult. It lies in the careful selectivity of the sexual partner, because, even using barrier methods of contraception ( condoms), there remains a high risk of spreading molluscum contagiosum from a sick person to a healthy one.

Secondary prevention of manifestations of molluscum contagiosum

For the purpose of secondary prevention, it is recommended to contact a dermatologist as early as possible if manifestations of the molluscum contagiosum virus are suspected. The earlier the disease is diagnosed, the sooner treatment can be prescribed. Treating several small foci is much easier and, ultimately, more effective than treating complicated forms of infection for a long time and with varying success. The sooner a person removes the manifestations of molluscum contagiosum, the less likely the pathogen is to spread to surrounding tissues and household items. Thus, early diagnosis and treatment of the disease prevents its spread to healthy tissues and the formation of an epidemiological focus in which other people can become infected.

How to treat molluscum contagiosum in children?

Treatment of molluscum contagiosum in children is generally similar to that in adults, but has some peculiarities.

First of all, you need to remember that children come in different ages. They usually learn to consciously endure pain from the age of entry into school, so from about 6-7 years of age children can be treated as adults. In most cases, molluscum contagiosum removal is virtually painless. However, the child must be prepared for what may be a little painful, but after that he will fully recover. Usually, this preparation is enough for the child to voluntarily agree to treatment.

It is strongly recommended not to treat children on their own at home. It is best to consult a dermatologist. There are several reasons for this. The main one is the high risk of improper removal of the focus, as a result of which the pathogen can remain on its bottom and then spread to healthy areas of the skin if the rules of asepsis and antisepsis are not followed.

In addition, children should not be treated only with ointments and creams. Due to hyperactivity, children often unknowingly injure foci of molluscum contagiosum, causing their spontaneous opening, suppuration and spread of infection. Therefore, when a lesion appears, it must be removed as soon as possible by a qualified specialist.

To remove skin elements in molluscum contagiosum in children, both the traditional method and modern methods are used.

The traditional method involves opening the top of the hearth, followed by squeezing its contents onto cotton wool with tweezers. The bottom of the resulting sore is carefully scraped out. Before and after the procedure, the focus and the skin around it are treated with antiseptic drugs.

Modern methods of removing molluscum contagiosum are also actively practiced on children. Removal of foci by laser and ultrasound is considered the most painless. Electrocoagulation and cryotherapy ( freezing with liquid nitrogen) is not practiced on preschool and younger children due to pain in the period after the procedure.

How to treat molluscum contagiosum in pregnant women?

Treatment of molluscum contagiosum in pregnant women follows the same principles as the treatment of this disease in other groups of patients. However, there are some special aspects of treatment that need to be mentioned.

During pregnancy, the body of the expectant mother gives the fetus a significant part of its own resources, which is why the health of the pregnant woman often worsens. One of the manifestations of deterioration in health is a decrease in the strength of immunity. As a result, infection with molluscum contagiosum virus can cause more problems than other patient groups.
More often, atypical forms of the disease occur with the rapid spread of foci to the entire body. Natural healing of lesions in pregnant women also usually takes longer.

Pregnant women often have a bacterial infection attached to the manifestations of molluscum contagiosum. Given the prevalence of manifestations, it may be necessary to prescribe antibiotics and antihistamines systemically, which is not very welcome during pregnancy.

Separate attention deserves cases of the presence of foci of molluscum contagiosum in the vagina, on the cervix and on the external genitalia. They must be cured before childbirth, in order to avoid infection of the newborn when passing through the birth canal.

Given all the above features of the course of molluscum contagiosum in pregnant women, the following conclusions should be drawn:

A pregnant woman should daily inspect the skin for manifestations of molluscum contagiosum, especially if there are carriers of this disease in the house and the immediate environment.
If the first foci are found, you should immediately contact a dermatologist and remove them as soon as possible, interrupting the spread of the infection.
Self-treatment of this disease by pregnant women at home is not recommended, due to the high risk of spreading the infection.
Treatment solely with medications without mechanical resolution of the focus is not recommended, since it is much less effective and longer due to a reduced level of immunity.
It is extremely important to visit a gynecologist in a timely manner in the prenatal period for the timely detection of manifestations of molluscum contagiosum in the birth canal and its timely treatment.

What are the methods of treating molluscum contagiosum at home ( folk methods of treatment)?

Treatment of molluscum contagiosum at home is not recommended due to the risk of spreading the infection to healthy areas of the skin and household items. However, if it is not possible to seek qualified medical help, then the skin manifestations of molluscum contagiosum should be removed as soon as possible, without waiting for the development of complications.

Two relatively safe methods can be used to remove molluscum contagiosum. The first method is to use celandine or super celandine. The second method is classical and involves opening the source of infection and treating it with antiseptic agents.

Removal of manifestations of molluscum contagiosum with celandine or super celandine concentrate
Celandine tincture is a toxic substance that literally burns the skin and any other soft tissues it comes into contact with. Super celandine is a concentrate of celandine, which has even greater aggressiveness towards tissues.

To remove the focus of molluscum contagiosum, it is enough to apply only a small drop of celandine extract to it. Do not wash the drop, you need to wait until it dries. Then, after a few days, the hearth will shrivel and dry. For small lesions 2-3 mm in size, one drop is sufficient. If the focus is larger than 2 - 3 mm, then 2 - 3 drops may be required. However, drops should not be applied immediately, but with a break of several days. When using this method, one should expect the development of an inflammatory process at the site of application of celandine. With the correct dosage of the substance, soreness may be minimal or completely absent. However, usually patients, striving to achieve a quick result, place a larger amount of a substance on the skin, which causes pain to be quite noticeable.

Removal of manifestations of molluscum contagiosum by the classical method
With the classical method of removing the manifestation of molluscum contagiosum, it is necessary, first of all, to treat the surface of the focus and adjacent tissues with antiseptic solutions. Most often, for this purpose, they first use a 5% alcohol solution of iodine, and then 96% alcohol.

After treatment, the focus is gently squeezed from the sides by the branches of anatomical tweezers until the curd mass is released from the umbilical compression in its center. If this does not happen, then it is not worth pushing hard. Instead, you should take a hollow needle from any sterile disposable syringe and carefully cut off the top of the molluscum contagiosum with it, and then repeat the extrusion procedure until the first drops of blood appear. The curd mass should be taken on cotton wool and in no case should it be allowed to come into contact with the skin. After that, as deep as possible into the center of the formed cavity, any antiseptic solution should be abundantly added ( 5% alcohol solution of iodine, betadine, fucorcin, brilliant green, etc.). In the next 5-7 days after opening the focus, it should be lubricated with antiseptic solutions 2 times a day, then for the same number of days, once a day. Usually these manipulations are enough to get rid of molluscum contagiosum.

How to treat manifestations of molluscum contagiosum on the penis?

Theoretically, the treatment of manifestations of molluscum contagiosum on the penis does not differ from that in any other localization. However, given the anatomical features of this organ, some more preferred methods of treatment can be selected.

At the time of treatment and until the disappearance of traces of the focus should refrain from sexual intercourse. More preferable are quick methods of treatment, which involve mechanical or surgical removal of the focus.
Ointments are used less often, due to the long recovery period, during which the foci are often accidentally damaged and inflamed. In particular, we apply the traditional method of removing the manifestations of molluscum contagiosum by opening it and then treating the sore with antiseptic agents.

Of the modern methods of removing manifestations of molluscum contagiosum on the penis, laser therapy, electrocoagulation and ultrasound therapy are used ( ultrasonic knife). These methods lead to a complete cure in up to two weeks and are characterized by painlessness and the almost complete absence of postoperative scars. Cryotherapy is not commonly practiced because it causes significant pain.

Are oxolinic ointment and viferon ointment effective in the treatment of molluscum contagiosum?

Oxolinic ointment and viferon ointment are definitely effective in the treatment of molluscum contagiosum, however, despite their effectiveness, these drugs are rarely used in practice due to the long duration of treatment.

Oxolinic ointment and Viferon ointment are used primarily for the treatment of the nasal mucosa during outbreaks of viral diseases. However, these drugs have sufficient antiviral effect to defeat the molluscum contagiosum virus. For greater effect, dosage forms with a maximum concentration of the active substance are used ( 3% oxolinic ointment and viferon ointment 40 thousand IU/g).

The advantage of this method of treatment is non-invasiveness, that is, there is no need to open the focus. However, this feature is also a disadvantage, since the duration of treatment with only local antiviral agents is from 2 to 6 months, during which the lesion may become inflamed or open spontaneously, leading to the spread of infection and the appearance of new foci.

In conclusion, it should be noted that this method of treatment can be used in adults if the focus of the disease is located in an area that is not subject to frequent injury. However, if the patient is a child or the focus is located in a traumatic area ( bra area, armpits, palms, feet, groin), it is better to choose faster methods of treating the manifestations of molluscum contagiosum.

Is cauterization of foci of molluscum contagiosum practiced?

Cauterization of foci of molluscum contagiosum is practiced. Moreover, cauterization is distinguished chemical, mechanical and physical ( laser).

Chemical cauterization is carried out with an extract of celandine, as well as an alcohol solution of iodine or brilliant green. These substances cause the foci to dry out within a few days ( in case of celandine) and within a few weeks ( in the case of an alcohol solution of iodine or brilliant green).

The procedure for mechanical cauterization of manifestations of molluscum contagiosum is called electrocoagulation. With this type of therapy, the tip of the instrument ( scalpel, loop or ball) in a fraction of a second is heated to several hundred degrees with the help of an electric current.
Then the focus is literally burned out, and a small cavity remains in its place, which is also treated with antiseptic substances and soon covered with scar tissue. This method is highly effective and has little pain.

Physical cauterization of a molluscum contagiosum involves its destruction with a laser. This method, in contrast to the above, is non-contact, and therefore implies a reduced risk of infection with hepatitis viruses, etc., due to insufficiently well-processed surgical instruments. Pain when removing the manifestation of molluscum contagiosum is minimal, so the method is successfully used even in intimate areas of the body.

Let's clarify right away: it has nothing to do with the Gastropoda family, like true mollusks, the causative agent of the disease, known as "mollusk contagiosum". This is a virus from the same group as the variola viruses of humans and some other animals, fortunately, the clinic and severity of the disease are not comparable.

Currently, the number of people infected molluscum contagiosum, is growing steadily. Doctors allocate several objective and subjective factors that contribute to the spread of the virus, among them :
- large crowding of the population in cities and metropolitan areas;
- deterioration of the ecological situation, in many people;
- an increase in the number of HIV-infected and AIDS patients who often become infected with molluscum contagiosum and are its carriers;
- increase in the number of sexual partners throughout life.

Briefly dwelling on each of these points, we can note the following points. Molluscum contagiosum, as a viral disease, is more easily contracted through daily contact with a large number of people, among whom may be infected with the virus. Previously, molluscum contagiosum was more often diagnosed in children who were more susceptible to infection with the virus due to an underdeveloped immune system. Nowadays, for various reasons, immunity can be weakened in adults, and infection is also easier for them.

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Most scientists do not classify molluscum contagiosum as sexually transmitted diseases. However, due to close skin contact during intimacy, the risk of infection increases.

Independent disappearance of external manifestations of the disease is most often observed after 6 months, a high risk of relapse persists up to 9 months. However, even after a complete “cure”, it is impossible to guarantee the absence of a possible recurrence of molluscum contagiosum: the virus remains in the human body for life. Stress, exacerbation of chronic diseases, transferred can “wake him up” and provoke another relapse.

Ways of infection with molluscum contagiosum can be as follows :
-contact, including during intercourse. In this case, there is direct transmission of the virus from person to person..
-domestic. The virus can be transmitted through various objects that a sick person has touched; you can get infected not only from a sick person in the house, but also in a swimming pool, public transport, a gym, etc..
Dermatologists tend to distinguish separate group outbreaks of molluscum contagiosum in kindergartens and schools. Usually there is a mixed type of infection, contact household, which can eventually lead to the disease of a large number of children.

It is possible to establish the source of infection at the initial stage of the disease. So, when infected during intimacy, initially the rash will be localized in the groin, on the genitals, in the lower abdomen or on the inner thighs. When infected household way the rash most often appears on the hands

and face.

For mixed type infections usually the rashes are quite extensive and can be located on different parts of the body.

The incubation period for molluscum contagiosum infection can last from several weeks to two months. The course of the disease includes two stages .

First stage: solitary few hemispherical rashes appear on the skin with a dent in the middle, the size of each is the size of a millet grain. The rash has a flesh-colored or slightly more pinkish color, the shell is quite hard, when pressed, a whitish curdled mass is released, the patient complains of itching.

Second phase: papules of the rash gradually soften and are damaged when combed, often an additional bacterial infection is added. Self-infection occurs through the hands, the number of rashes and affected areas of the body increases.

When pressing on the middle of the papule, they stand out, resembling mollusks, and a large number of lymphocytes.

Ultimately, usually after about six months, the body itself copes with the virus and the external signs of the disease disappear.

There is no specific treatment for molluscum contagiosum. After the final confirmation of the diagnosis on the basis of the clinical picture of the disease and laboratory tests of the contents of the vesicles, the doctor usually tries to determine the source of infection and, if possible, limit the patient's contact with other people. The patient is advised to strictly follow personal hygiene rules, adhere to special plant-based diet with restriction fatty, salty and sweet. In addition to vegetables and fruits rich in vitamins, the intake of complex multivitamin preparations. In case of bacterial infection, rashes are prescribed antibiotics. At severe course diseases, with multiple rashes and a significant weakening of the immune system, can be used antiviral drugs local and general action (most often based on Acyclovir), as well as various immunomodulators.

Fortunately, surgical method removing the rash with molluscum contagiosum by cutting off the papules and scraping them, has actually remained in the past. However rash burning and squeezing out the contents of the bubbles by a dermatologist with subsequent treatment with iodine, alas, are still practiced today. In the early stages of the disease, a good result is given cryotherapy (freezing papules with liquid nitrogen) and laser cautery individual few rashes.

Self-medication in the case of molluscum contagiosum is strictly not permissible : in addition to the fact that its skin manifestations can easily be confused with other diseases (in particular, with neoplasms on the skin), in some cases the appearance of this infection may be associated with HIV infection and AIDS.

ethnoscience to reduce itching with molluscum contagiosum recommends lotions from infusion of succession or calendula. You can also wipe the affected areas alcohol tincture calendula, Rotokan(calendula + chamomile) - these preparations are additionally well dried and disinfected.

Preventive measures aimed at preventing infection with molluscum contagiosum are quite simple.:
- strictly observe the rules of personal hygiene, be sure to teach this to children;
- after returning home, wash your hands immediately, especially after traveling by public transport, shopping, visiting public places;
- never use other people's washcloths and combs, do not let strangers "vilify" their things;
- after the pool, bath or sauna, be sure to take a shower, monitor the condition of the skin;
- strengthen immunity - include more in your diet fresh vegetables and seasonal fruits, spend more time outdoors;
- be selective when choosing sexual partners;
- if there is a patient in the house, change his bedding and underwear daily (washing + disinfection is necessary, at least by boiling), wipe your hands often with disinfectant solutions.

Good health to all!