30 yrs old female presented with these types of multiple pappular lesions on left side of cheek of face since last 3 months.No other presenting complaints. No pain,itching, oozing. Her husband n son also has similar lesions. Diagnosis n Treatment. ..?

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Dx :- Molluscum contagiosum (MC) . In a sexually active woman at the age of 30, one should look for the sources of acquiring MC, whether sexually transmitted (To look same lesions present over genitalia ) or acquired from kids/children (Non sexual transmission). HISTORY will elicit the fact. ** Adv. - Anti HIV 1&2 antibody test. MC, is a DNA virus belongs to the FAMILY POXVIRIDIAE. If patient or her child comes into contact with the M. contagiosum virus, she may not see symptoms of infection for up to six months. The average INCUBATION PERIOD is between two and seven weeks. She may notice the appearance of a small group of painless lesions. This common skin disease causes bumps on the skin and tends to be harmless. ** As MC is a highly contagious disease , people can get molluscum by sharing towels and clothing. Wrestlers and gymnasts may get it from touching infected mats. SKIN-TO-SKIN CONTACT also spreads the virus. ** Once infected with the virus, a person can spread the virus to other parts the body. Scratching or picking at bumps on the skin and then touching skin that does not have bumps can spread the virus and cause new bumps. Rx :- When a CHILD gets this skin condition, researchers have found that the SKIN OFTEN CLEAR ON ITS OWN. Clearing takes ABOUT 12 to 18 MONTHS. In many cases, children are not treated because treatment can have unwanted side effects for a child. While molluscum can clear on its own, treatment has benefits. Treatment helps to prevent the virus that causes molluscum from :- a) Spreading to other parts of your body. b) Infecting other people. c) Growing out of control in people who have a weakened immune system. For each patient, a Dermatologist considers whether treatment is appropriate. If treatment is recommended, the TREATMENT PLAN may include one or more of the following :- Procedures: Dermatologist can perform these during an office visit: 1) CRYOSURGERY: The dermatologist freezes the bumps with liquid nitrogen. 2) CURETTAGE: The dermatologist uses a small tool called a curette to scrape the bumps from the skin. 3) LASER SURGERY: A dermatologist uses a laser to target and destroy the bumps. This can be an effective treatment for people who have a weakened immune system. 4) Topical (applied to the skin) therapy: Dermatologist can apply various acids and blistering solutions to destroy the bumps. These WORK BY DESTROYING the TOP LAYERS OF the SKIN. i) TRICHOLORACETIC ACID is often used to treat people who have a weak immune system and many bumps. When a patient has many bumps or large bumps, a dermatologist may need to REPEAT a procedure every 3 to 6 weeks until the bumps disappear. These procedures cause some DISCOMFORT. ii) MEDICINE one APPLY AT HOME: Medicines that your dermatologist may prescribe for you to use at home include: A) IMIQUIMOD: This medicine is applied to the bumps. Imiquimod helps your immune system fight the virus. This is strong medicine. It also is used to treat stubborn warts and some skin cancers. B) RETINOID or ANTIVIRAL MEDICINE applied to the skin: Patients apply this medicine to the bumps as instructed. ** While treating molluscum, it is normal for new bumps to appear as others fade. OUTCOME :- If a person with a HEALTHY IMMUNE SYSTEM opts not to treat molluscum, the BUMPS will EVENTUALLY GO AWAY on their own without leaving a scar. ** Until the bumps go away, the person is contagious. ** When a patient choose to treat molluscum, may get new bumps for as long as 6 months after start treatment. **Most people, however, have complete clearing in 2 to 4 months. It's IMPORTANT TO REMEMBER that until the bumps clear, the infected person can give molluscum to others. ** If a person has AIDS or another disease that weakens the immune system, the BUMPS WILL NOT GO AWAY WITHOUT TREATMENT — and the bumps can be a CHALLENGE TO TREAT. **Dermatologists often COMBINE TREATMENTS to offer these patients some clearing. COMPLETE CLEARING MAY NOT BE POSSIBLE.

Multiple polymorphic umblicated top lesions around the mouth without itching and pain more favour to MOLLUSCUM CONTAGIOSUM. It is viral infection caused by MC virus.highly contagious. TREATMENT; 1) Remove of MOLLUSCUM bodies from lesions. 2) After applying TCA on lesions. 3) Cap vit E give for 1 month course.

Thanks sir. .

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Nise questions Dr. Girish and Dr. Sangeeta. Welcome your questions. Regarding Dr. Girish's question, RECURRENCE: Sir, MC is highly contagious and infectious. If once infect the person, it will give lifelong immunity like HERPES. But recurrence is seen only in impaired immune status. Ex .HIV or AIDS, who are taking antimetabolite medicines and over use of steroids, in children atopic dermatitis.And sexually active couples, this virus fluctuates and modify its antigen property. So again and again it will recur, while contact. TCA: It prevents spreading the virus. It won't prevent the recurrence in above said individuals. ANTIVIRAL PART: There is no role of these medicines in the MC . If you use, it will disturb the newly active antibodies formation. Common features of WARTS and MC : 1) Both are caused by VIRUS 2) Both produce common clinical problems in children. 3) Both have contagious property and Sexually transmitted. 4) Both are appearing single or groups. These are common on exposed parts .

Sorry HERPES means HERPES ZOSTER. Regarding Dr .Sangeeta question, Usually we are using 25% TCA But in market availabile only 10 %.

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Molluscum contagiosum . Rx : *A trial of oxytetracycline orally may help. * Incision in middle of lesion helps resolve it.

A case of multiple molluscum contagiosum. Such multiple lesions can plant the seed of doubt regarding immunocompromised state. Invstigate for DM, HIV etc. Treatment simple needle cautery with phenol brings good results. Needle expulsion of molluscum bodies followed by Tr. Benzoin cautery also is helpful.

Molluscum contsgiosum . Nicely described by @Dr. Puranjoy Saha sir and @Dr. P.kishore Kumar sir. Agree with them.

@Dr. Girish Dahake Molluscum Contagiosum There is no single perfect treatment of molluscum contagiosum since we are currently unable to kill the virus. In many cases no specific treatment is necessary. Physical treatments include: Picking out the soft white core (note, this could lead to autoinoculation)Cryotherapy (can leave white marks)Gentle curettage or electrodessication (can scar)Laser ablation (can scar) Medical treatments include: Antiseptics such as hydrogen peroxide cream or povidone iodine solutionPodophyllotoxin creamWart paints containing salicylic acidCantharidine solution Imiquimod cream and sinecatechins are sometimes used but are unproven. Secondary dermatitis may be treated symptomatically with a mild topical topical corticosteroid such as hydrocortisone cream. It is unlikely to fully resolve until the molluscum infection has cleared up.

Molluscum contagiosum. I agree with Dr P .kishore sir

Thank you Dr. Simmi


Molluscum contagiosum- radiofrequency or electrocautery can be done

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