There is a false belief that links contagious molluscs with fungi and their appearance in swimming pools or humid environments. Although both parties are usually linked, the transmission is different from what is believed . This is explained by Ana Martín-Santiago, dermatologist at the Piel Sana Foundation of the Spanish Association of Dermatology and Venereology (AEDV).
It notes that molluscum contagiosum (MC) has little to do with fungi. “It is an infection caused by a virus of the pox-virus family, Molluscum contagiosum , hence its name.” A pathology that is transmitted by direct skin-to-skin contact or through objects such as towels or shared clothing. “Therefore, in environments such as swimming pools or gyms, cases tend to increase,” says the specialist.
Stephanie Patrizia Barbeito Pagliuca, member of the Dermatology Group of the Spanish Society of General and Family Physicians (SEMG) adds: “The disease has a universal distribution, with a highly variable incidence, depending on geographic areas. It is estimated that 2-5% of the population will suffer worldwide . ”
One of the groups with the highest exposure is children with atopic dermatitis because scratching the molluscum contagiosum spreads to the rest of the body . However, although children and adolescents are more exposed to the virus, they are not the only ones who contract it. “Its appearance is also associated with immunosuppressed patients and adults with sexual activity, ” says Begoña Fornes Pujalte, vice president of the National Association of Dermatological Nursing and Investigation of the Impairment of Skin Integrity (Anedidic) and nurse of the Hospital Ulcer Unit. General of Valencia .
Jorge Zamora Ortiz, treasurer of Anedidic and nurse at the Valencia Dermatology Unit, clarifies that when molluscs appear on the genitals, it is usually in the pubis . He also warns that “ the waxing of these areas is a traumatic factor for autoinoculation . It must be treated with the dermatologist if it is external. And in the case of being internal molluscs, which are not common, it will be dealt with directly by the gynecologist or urologist ”.
How to detect them?
The appearance of the MC is characteristic and easy to recognize: they are small lumps of less than 2 to 5 millimeters, hemispherically shaped with a central depression and with a bright color, sometimes pink . “They are firm, painless, round bumps that vary in size and can be like the head of a pin or the eraser of a pencil,” explains Stephanie Patrizia.
They can appear anywhere on the body , according to Begoña Fornes. “In the case of adults, the most common is to find them in the groin, armpits, neck, face, hands, thighs, lower abdomen and genitals, as they are frequently a sexually transmitted infection. Only in exceptional cases, lumps can appear around the eyes or mouth, “he adds.
They do not usually show other symptoms, although sometimes they get red or a dermatitis appears around them, but without itching. “We must pay special attention to scratching because the area of the papule contains the virus inside as a liquid. Normally with the rubbing it breaks and goes outside. And it is at this point that self-infection is very likely and can contaminate other areas of the body , even causing conjunctivitis ”, warns Jorge Zamora.
The dermatologist Ana Martín-Santiago indicates that there are seven keys to reduce the risk of contagion: avoid sharing clothes and towels ; take care of the skin using non-irritating hygiene products ; use moisturizers ; showering better than bathing; wear clothing that covers the affected areas; avoid traumatizing the skin with scratches and shaves ; and adequately treat atopic dermatitis or other possible skin diseases that are present.
But above all, he stresses: “Children with molluscum contagiosum should not be excluded from daycare, school or sports activities .” In fact, MC is a self-limited pathology that resolves without treatment in individuals without immune problems . “In fact, there are dermatologists who do not remove them. They just let them get involved, ”says the Anedidic vice president. And he clarifies: ” Care must be taken in atopic patients and in immunocompromised individuals , since their evolution can be prolonged.”
In general, the active treatment of mollusc should be considered when “the resolution of the disease is slow, over four months, the lesions are symptomatic, causing a deterioration in the quality of life of the patient or if there is an association with eczema, mainly in patients with atopic dermatitis ”, responds dermatologist Ana Martín-Santiago.
According to Barbeito Pagliuca, the specialist can carry out different treatments to shorten its growth or prevent its spread. The contagious center can be removed by squeezing the lumps with a scalpel or forceps . Remove the growths by freezing them ( cryotherapy ) or scraping them with surgical instruments (curettage). It is also possible to apply a cream or chemical agent , such as salicylic acid, tretinoin, cantharidin, or another wart medication. Or prescribe an oral treatment for cimetidine.
In the event of having been burned or removed, the area must be treated with antiseptic to keep it dry , continue with good hand hygiene with soap and water and avoid sharing towels or personal hygiene items. “In the case of children with atopic skin, it is advisable to keep the area hydrated to avoid wounds and skin damage,” says Begoña Fornes.