Signs and Symptoms

Molluscum Contagiosum Signs and SymptomsSo, what are some of the signs and symptoms of this most common skin infection which is estimated to affect between millions of people around the world?

Symptoms are what a sufferer feels and reports.

Signs can be seen by the sufferer and also seen or detected by other people, such as a doctor.

Quick Facts

Molluscum Contagiosum

  • has an incubation period of between 2 weeks and 6 months
  • may first appear as pinhead bumps on the skin
  • bumps may range in size from that of a pinhead to a pencil eraser
  • bumps are usually  small and dome-shaped with pink or flesh-coloured appearance
  • growths are usually dimpled and contain a white, cheesy like substance
  • bumps usually feel smooth or waxy to the touch
  • is usually painless and symptom free apart from the bumps
  • molluscum contagiosum in children usually affects the face, neck, arms, armpits and hands but they can also pop up on the chest and back.
  • molluscum contagiosum in adults usually affects the genital area (on or near the penis, vulva or vagina), buttocks, abdomen, inner thighs,  or anal area.

Grab a cuppaGrab a Cuppa

Some more science.

Incubation Period

The incubation period for the virus is anywhere between 2 weeks to 6 months with an average of around 1-8 weeks for the infection to show up. It is practically impossible to find more accurate figures about the incubation period and the length of time the infection may persist as the figures vary from one expert to another, so the figures used here represent the most popular estimates.

Molluscum Contagiosum Bumps

The molluscum contagiosum rash usually starts off with a pinhead like appearance similar to goosebumps but can enlarge rapidly into small, firm, dome-shaped bumps, usually measuring about 3-6 mm (0ne-eighth to one quarter inch) although some may be as big as 3cm (1.2inches) around, so the sizes of the bumps can range from that of a pinhead to a pencil eraser.

The growths may be referred to as bumps, papules, pustules, sores or lesions.

They are usually painless, and feel smooth or waxy to the touch which is why they are often referred to as ” pearly warts”.

The bumps are usually pink or flesh-coloured.

A characteristic of a molluscum contagiosum infection is that it is usually mild and asymptomatic ( meaning it does not cause vomiting or fever as happens with say, chickenpox), but in some cases, the sufferer may experience pain, tenderness or itch on the bumps or the surrounding areas.

Over time, the center of the bump becomes soft and indented and looks like a dimple.

This dimple is usually filled with a thick, white substance, which can be described as waxy, cheesy or curdlike.

If this waxy substance is removed from larger bumps, it will probably remain intact and have the appearance of a small pearl.

There may be some bleeding or milky white fluid on removal of the centre, but there will be no pus as there would be with something like acne.

This substance is teeming with the molluscum contagiosum virus, and it is the only virus activity which can be seen by the human eye.

There may be some redness or scaling around the edges of the sores from swelling, and particularly if the sore has been scraped or scratched.

For people prone to eczema, it is common for patches of eczema to develop around the molluscum bumps around about a month after they have first appeared on the skin.

Each bump has its own contagious centre.

There may be single bumps or lesions, but they more usually appear in clusters.

Touching or scratching the sores may lead to them spreading in a line, or in groups called crops. The bumps may become inflamed or redder in appearance over time as the sufferer’s immune system kicks in to fight the virus.

If a bump is really inflamed it can look like a boil.

But, because the molluscum contagiosum virus is very good at evading detection by the body’s immune system, an infection can persist for an average of 12-18 months or 2-4 years in some cases.

The molluscum contagiosum virus can be frighteningly unpredictable. A sufferer could have a small number of bumps on an area of their body for months and then, as if overnight, it has dramatically spread like wildfire over extensive areas of the body.

It is quite common for the bumps to cluster in a few locations, or they could be dispersed over different parts of the body or a mixture of both.

The number of sores can vary from a few to hundreds.

Unfortunately, the sores may also come together to form very large sores, particularly for those with impaired or weakened immune systems in circumstances cases where people have cancer or HIV, or taking treatments such as steroids, which trigger impairment of the body’s natural defence mechanisms.

However, the presence of molluscum contagiosum on its own does not indicate the person has serious hidden medical problems; they have simply fallen victim to contact with this highly contagious virus.

The mucous membranes (such as the mouth or conjunctiva, the membrane that covers the eyes) may also be affected, but this is not common.

Sores may occur anywhere on the body except the scalp, palms and soles of the feet.

Molluscum Contagiosum in children, usually causes bumps to appear on the face, neck, arms, armpits and hands but they can also pop up on the chest and back.

In teenagers and adults it is common for the bumps to appear on the genitals, pubic, genital and perianal areas, abdomen and inner thighs, if the virus has been contracted through sexual activity ( not restricted to sexual intercourse).

In immunocompetent persons,that is people who do not have any problems with their immune systems, the infections usually spontaneously resolve within 6-18 months, although genital sores may remain for much longer.

In HIV infected individuals, the sores may be a lot more extensive and consistent.

There is a strong connection between the degree of immunosuppression and the risk of molluscum infection, the number of sores, and the ability of the lesions to resist treatment.

Because the skin virus exists even where there are no visible bumps, new crops can appear over time, even after treatment of original bumps.

When the molluscum infection eventually does spontaneously resolve and the bumps go away, a tiny area of lightened skin may remain, or small pitted marks, but usually no scars.

When the condition starts to heal there may be some redness or scaling around the healing molluscum bumps.

Virus DetectedThis is called a dermatitis halo and is a sign of impending spontaneous regression meaning the molluscum is clearing.

The sufferer’s immune system has finally recognised the presence of the virus and is now producing antibodies to fight it off.

The centre of the dimples may look blackened in bumps where the virus us dying off.

Tests and Diagnosis

If you suspect you or your child may have molluscom contagiosum, make an appointment as soon as you can with your doctor.

There are a number of other skin conditions which may appear similar to molluscum, such as warts, chicken pox or even skin cancer, so consulting your own physician as soon as possible is a must.

As there are thousands of people diagnosed with this condition every year, experienced health providers will usually make a diagnosis on examination of the bumps based on the typical appearance of the rash and following discussion about the symptoms.

Diagnosis by visible signs and discussion of symptoms is usually straightforward.

However, if  the doctor is not sure, or if one of the bumps looks different to the rest, she may take skin scrapings from the infected area and examine under a microscope, just to be sure and to rule out the possibility of something more serious.

This is known as an excisional biopsy, or skin biopsy.

The scraping is not painfu,l but can be a little uncomfortable for a very short period of time.

It is important to get an accurate diagnosis so that immediate action can be taken to stop the spread of the infection on the sufferer’s skin and to cut down the chances of passing it on to other people.

The doctor may make a rererral to a dermatologist ( a doctor specialising in skin diseases).

If there are mollusca present on the genitals, the doctor may refer the client to a genitor-urinary medicine (GUM) clinic to be checked for other STDs and, again, rule out the possibility of another, more serious condition.

A referral to a specialist may also be made if the eyelid or the eye is red, if the client is HIV positive or the client has a lowered or faulty immune system as in these cases, the molluscum contagiosum infection may be more severe, more resistant to treatment and more prone to complications.

More Reading : Molluscum Contagiosum : Complications

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