Sexually transmitted diseases - Molluscum Contagiosum

Molluscum contagiosum, a cutaneous and mucosal eruption caused by a Molluscipox virus, is a viral infection first described and later coined by Bateman in the commencement of the nineteenth century. In 1841 Henderson and Paterson defined the intracytoplasmic inclusion bodies now generally known as molluscum or Henderson-Paterson bodies. In the early years of twentieth century, Juliusberg, Wile, and Kingery were able to siphon filterable virus from lesions and show transmissibility. Goodpasture later defined the similarities of molluscum and vaccinia. It was thought to infect only humans before however case reports of the virus appearing in other animals have also been published.

Molluscum contagiosum causes sporadic but few lesions/bumps and is generally a benign contraction and the symptoms may most of the time self-resolve. It has been believed to be a disease that primarily affects only children however it has eventually evolved to become a sexually transmitted disease in adults. It is considered to be a member of the pox virus family but may cause serious and critical complications in people with immunodeficiency disorder and AIDS infection.

The disease is primarily spread through direct skin-to-skin contact with an infected individual. Fomites have been suspected as another source of infection, with molluscum contagiosum reportedly derived from bath towels, tattoo instruments, and in beauty parlors and Turkish baths but they are infrequent in adults. The infection to other areas of the body can be spread through scratching, picking, or breaking the blisters. Transmission through coitus and other sexual activities are the most common for adults.

The incubation period from the time of initial contact until the molluscum or spots appear is between 2 and 7 weeks with a range extending out to 6 months. Hyperplasia and hypertrophy of the epidermis is often caused by infection with the virus. Free virus cores can been found in all layers of the epidermis as well as so-called viral factories can be located in the malpighian and granular cell layers. The molluscum bodies carries with it large numbers of maturing virions and are contained intracellularly in a collagen-lipid-rich saclike structure that usually is thought to deter immunological recognition by the host. Instead of the usual necrotic pox lesion associated with other poxviruses, MCV induces a benign tumor.

Lesions usually start to appear on the thighs, groin, buttocks and lower abdomen of adults, and may perennially appear on the external genital and anal region. Children only develop lesions on the face, legs, trunk and arms. They may begin as small bumps which can gradually develop over a period of several weeks into a much larger sores/bumps. The lesions can be flesh colored, yellow, gray-white or pink and more often can cause itching or tenderness in the area, however in the usual cases the lesions cause only a few problems but can last from 2 weeks to 4 years -- the average is 2 years. The size of the papule can be variable and depends upon the stage of development, usually averaging between 2–6 mm. Further, papules may exceed 1 cm in size in immuno-suppressed hosts. People infected with AIDS or others with already a compromised immune system most definitely to develop extensive outbreaks.

In most cases, patients manifest asymptomatic lesions and are complicated only by secondary bacterial infections. This may somehow cause itching and consequent eczema surrounding the tumors. The central waxy core also contains the virus. In a process called auto-inoculation, the virus may contracted to neighboring skin areas.

There are a lot of known treatments and medications for the MCV. The usual ointments and scrubs such as Retinoids, Betadine surgical scrub, salicylic acid, and tretinoin creams may help in slowly getting rid of the lesions.

Other methods are foremostly surgical treatments that include:

• Cryosurgery, in which liquid nitrogen can be used to freeze and destroy lesions as well as scraping with a curette;
• Pulsed dye laser therapy for molluscum contagiosum for multiple lesions;
• Evisceration;
• Curettage;
• Tape stripping;
• Podophyllin and podofilox;
• Cantharidin.

Since transmission through sexual contact is primarily the most common form of transmission for adults, preventing skin-to-skin contact with an infected partner will certainly be the most effective in preventing MCV.

Latex condoms or other moisture barriers for vaginal, oral, and anal sex may somehow help to prevent such contact. Limitations of such barriers must be recognized as MCV does NOT require mucous membrane contact to be passed.

Using spermicides is not at all recommended since they can just irritate the skin or vaginal tissue and, especially for women, cause abrasions that may make it easier to contract STDs/STIs.