Molluscum dermatology. Use of general drug therapy. Routes of transmission and infection

The main route of occurrence of the disease is contact with the skin of a sick person. Rashes are usually concentrated at the point of contact; it is in these areas that papules appear.

The main causes of infection with molluscum contagiosum:

• Sexual contact with a carrier of the disease.
• Lack of personal hygiene.
• Unsanitary living conditions.

Infection can occur when visiting a sauna, bathhouse, or swimming pool. An epidemic outbreak is possible in children visiting kindergarten, school.

How does molluscum contagiosum manifest?

What do skin rashes look like when you are sick? Papules resemble hemispherical nodes, in some cases they are flattened. The size of each nodule at the first stages of the disease is equal to the head of a pin. Gradually, the rash increases, each nodule becomes the size of a pea. Peculiarity molluscum contagiosum– when you press on the papule, a whitish discharge resembling a cheesy mass is released from the recess.

Where are the rashes located? Papules appear on:

• face,
• breasts,
• in the groin area,
• on the genitals,
• on inner surface hips

Nodules on the palms and soles are extremely rare. In patients with low immunity rashes occupy a large area of ​​the skin.

How does a patient with molluscum contagiosum feel? The papules are painless, the symptoms do not cause any subjective sensations. Sometimes there may be slight itching, but it appears when scratching.

Treatment methods

Outpatient treatment involves the following procedures:

• Surgical removal - curettage. It is carried out once a month.
• Laser removal.
• Treatment with chemotherapy drugs. But they are not recommended for long-term use due to their adverse effects on the skin.

Therapy is carried out comprehensively, adding to the above described actions medications. During treatment, you cannot visit common areas; you need to disinfect your sleeping area, bathtub, and personal hygiene items more often.

Treatment at home

If you don’t want to resort to unpleasant procedures, it’s worth a try self-treatment molluscum contagiosum using folk remedies. Prescriptions can speed up recovery traditional medicine, having antiviral effect. Proven recipes for treatment in adults and children:

• Eucalyptus ointment and calendula tincture. This solution is treated pathological formations three times a day.
• Collecting a string fill with water and bring to a hot state. For one glass of water, take two spoons of the mixture. Ready decoction cover and leave for an hour. The resulting tincture is used to wipe multiple rashes three times a day.
• Garlic refers to natural antiviral drugs. Garlic ointment is used three times a day. To prepare the ointment, the head of garlic is crushed to a thin paste. Add a spoonful of butter to the mixture and mix. If the skin tolerates garlic treatments well, then it is not forbidden to wipe the nodules with a slice six times a day.
• Celandine juice Apply to papules twice a day. You can make a solution from the plant yourself or buy it at a pharmacy. When using celandine, precautions should be taken. Avoid contact with healthy areas of skin, wash hands thoroughly after procedures, avoid contact with eyes.
• Juniper berries, three spoons of birch buds, yarrow herb, eucalyptus leaves, pine buds and calendula flowers are brewed with boiling water and then infused. The resulting tincture is filtered and used for wiping the skin and for oral administration. The course of treatment is 2 times a day, a tablespoon. Duration - about two weeks.

Important Note: When treating at home, you should not squeeze out papules yourself. This action can complicate the course of the disease.

What you need to know about prevention

To reduce the likelihood of becoming infected with molluscum contagiosum, you should follow simple rules.

• Don’t forget about personal hygiene and teach your children to be clean. It is advisable to iron your underwear with a hot iron and wash your hands frequently. Toys that are used outdoors should be washed once a week.
• To strengthen your defenses, it is important to walk more, do not forget about physical activity, healthy eating. A decrease in immune strength complicates the treatment of the disease.

The fight against molluscum contagiosum takes some time, but before starting treatment at home, do not neglect a visit to the doctor. Only a specialist can make a correct diagnosis.

From the following video you can learn even more details about molluscum contagiosum:

Children's the immune system is less developed compared to an adult, so a child has a higher risk of various infectious diseases, one of which is molluscum contagiosum.

This viral infection which causes unusual formations on the surface of the skin in the form of nodules, similar to mollusks. We will talk about the treatment of molluscum contagiosum in children in the article.

How to remove plantar wart The child has? Find out about this from ours.

Concept

Molluscum contagiosum in children - photo:

This is a viral infectious disease common among preschool children, however, it sometimes occurs in adults.

The causative agent is one of the viruses belonging to to the group of smallpox viruses. The disease causes a rash on the skin, most often on the mucous membrane and soft tissues, in the form of formations - peculiar pink or flesh-colored mollusks.

After infection, the virus penetrates into areas of the surface of the human body that are favorable for its development, and then introduces its DNA into cells, changing their structure.

As a result, abnormal cell growth and division occurs, and plaques appear that are shaped like a clam or.

How does infection occur?

Usually the virus is transmitted in household conditions through direct contact between people, so the disease may be epidemic in kindergartens, schools and other social institutions.

Transmission through personal hygiene products is also possible: towels, soap, Toothbrush, underwear, etc.

Special risk infection is observed in rooms with high humidity and air temperature, such as a swimming pool, locker room, bathhouse, etc.

Research has shown that clam nodules contain a large number of liquid containing a huge amount of virus. That is, if the formation bursts, then environment millions of pathogens are released.

They can move in space together with dust and air, as they are extremely small.

However, when exposed to high or low temperatures, they die.

Causes

The main cause of this disease is virus infection through direct contact between people or through surrounding objects. The following factors may contribute to this:

• weakened immune system;
• skin damage (wounds, burns, cuts);
• the presence of another infectious disease or recent illness;
• poor nutrition;
• and minerals in the body;
• lack of personal hygiene;
• frequent presence in crowded places;
• Availability .

More susceptible to the disease than others children from 1 to 5 years old.

Symptoms

The first weeks after infection occurs incubation period.

This process can take from 2 weeks to 1 month. Then nodules begin to appear on the skin.

At first they are only slightly noticeable, but gradually they grow and become like mollusks with a white or yellow dot in the center. Inside the nodules fluid accumulates.

Most often, formations appear on the abdomen, buttocks, face, neck and thighs, as well as on the mucous membranes of the mouth and throat. The nodules are round or oval shape bodily or Pink colour size up to 5 mm.

Over time, the formations may darken and become brown, and fluid from them can leak and cause itching or burning.

Types of disease

This disease has several varieties:

1. Classical- single hemispherical nodules with a depression in the center appear on the surface of the skin.
2. Generalized- large formations are observed on the surface of the skin, collected in clusters of up to several dozen pieces in one place.
3. Gigantic- formations merge into one large nodule up to 2 cm in size.
4. Pedicular- nodules merge into flat plaques, covering large areas of the skin.

Consequences and complications

In most cases, the disease proceeds without complications.

IN in rare cases Various developments are possible against the background of skin lesions from molluscum contagiosum.

There is also a risk of penetration and development of other infectious diseases, since immunity is weakened.

How does urticaria manifest in children? find out right now.

Diagnostics

An experienced doctor only needs to visually examine the patient to make a diagnosis. However for differentiation of rashes with similar symptoms, for example, human papillomavirus, polyp, dermatofibromyoma and various tumors, additional research is being carried out:

• general blood analysis;
• histological studies of molluscan bodies in the blood;
• microscopic examination of formations;
• biopsy of formations.

Based on the data received, the doctor will diagnose accurate diagnosis and will appoint appropriate treatment.

Treatment methods

How to treat the disease? In most cases, doctors recommend refrain from treatment.

The immune system itself must cope with the disease within 3-6 months.

However, in some cases, if the immune system is too weak, therapy is essential.

Therapy is aimed at suppressing the virus to prevent its further spread, as well as strengthening the immune system.

Medicines

Used for treatment the following types drugs:

• antiviral(external gels and ointments) - for external treatment of formations on the skin (Fukortsin, Tazorac, Retin-A, Aldara);
• antiviral(tablets) - for oral administration (Anaferon, Pranobex, Isoprinosine);
• immunomodulators- to strengthen the immune system (Cycloferon and Interferon).

This disease is often accompanied by other infections (usually bacterial), so tetracycline antibiotics (Tetracycline, Chlortetracycline, Oletetrin, Metacycline) are additionally prescribed.

You will find specialists in the treatment of impetigo in children on our website.

Folk remedies

In some cases, the healing time can be shortened if you use traditional medicine.

They mainly help achieve better cosmetic effect by removing the formations themselves.

Let's look at some useful and effective recipes:

1. Garlic. It is necessary to lubricate each knot with garlic juice every day. The result will be noticeable in a few weeks.
2. A series. For 1 liter of water, take 2 tablespoons of string, put on fire and bring to a boil. Cook over low heat for 15 minutes and remove from the stove. After cooling and filtering the broth, it is used to treat the affected areas of the skin. After some time, the nodules will open and a colorless liquid will flow out of them. After this, instead of a decoction, you should start treating the formations with iodine. Within 1-2 weeks, the wounds will heal and there will be no trace of the rash.
3. Celandine. It is enough to simply lubricate all the plaques on the skin with celandine juice. The course of treatment usually lasts 3 months. The shellfish will dry out and fall off on their own.
4. Potassium permanganate. It is necessary to treat the rash with a manganese solution (5%) every day. The plaques should soon fall off on their own and the wounds should heal. There are no scars left.
5. Period. The most unusual way. It is necessary to treat the shellfish with the mother's monthly secretions for a week. After this, remission should occur. It is believed that in this way the mother passes on her immunity to the child. The effectiveness of the method is unknown, but traditional healers claim that the method works.

Removal

This method does not eliminate the virus itself from the body, but only eliminates the external manifestation in the form of a rash.

That's why this type treatment must be associated with drug therapy antiviral agents, to avoid relapse.

Today, there are several ways to remove shellfish:

1. Cryodestruction- treatment of formations with low temperature liquid nitrogen. Healthy tissue remain unharmed, and pathologies die and fall off. The method is quick and painless.
2. Diathermocoagulation- cauterization of formations electric shock, which precisely creates high temperatures that are destructive for mollusks. The procedure is carried out under local anesthesia.
3. Laser— removal of formation with a directed high-power laser beam. The formations are burned out, and not a trace remains of them. The procedure is performed under local anesthesia and leaves no scars.
4. Mechanical removal- this is the simplest surgery under local anesthesia. The surgeon will use a scalpel to remove all pathologies. Fast and painless.

The virus cannot be completely destroyed, only suppressed. If immunity weakens in the future, a relapse is possible.

According to Dr. Komarovsky, a child does not need to be “poisoned” with pills or “experimented” with the help of folk remedies. He advises not to treat children at all if there is no threat to their life and health.

It is enough to strengthen the immune system so that the body can cope on its own.

If the rash is in unpleasant place or the child has a complex because of this, then you can contact a cosmetologist and remove the formations, however, this too, according to him, undesirable.

Prevention

To prevent this disease You should follow these helpful tips:

• monitor the state of the child’s immune system;
• Healthy food;
• adhere to the rules of personal hygiene;
• avoid contact with sick children;
• treat any infectious diseases in a timely manner;
• Regularly undergo medical examinations with a pediatrician.

Molluscum contagiosum does not pose a serious threat to a child's health. However, this is an alarm bell that indicates weak immunity.

This means that there is a risk of other diseases, much more serious.

If the disease appears, then you need to go through everything necessary examinations see your doctor and then follow his recommendations. You may not have to undergo treatment at all, and all your efforts will be aimed at strengthening your immune system.

What to do with molluscum contagiosum? Doctor Komarovsky will tell you in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Children's skin is so sensitive to everything around it that the various rashes on it sometimes do not even surprise parents. However, there are skin ailments that many mothers and fathers have never even heard of. However, these diseases often affect children. About what it is molluscum contagiosum and how to treat such an illness in a child, we will tell you in this article.

What it is

Molluscum contagiosum is a skin disease of viral origin. It mainly affects the skin, but sometimes the mucous membranes are also affected. The characteristic clam shell-like rash on the skin is caused by a virus that belongs to the smallpox group, but is not smallpox as such. It is considered close to smallpox.

This virus can only infect people; animals do not get sick from it and do not tolerate it. Moreover, most often the insidious agent attacks children from birth to ten years. There are four types of this virus in total. The first and second, designated by the corresponding serial numbers after the name of the pathogen MCV, are usually transmitted sexually. This is an adult disease.

But MCV-3 and MCV-4 are types of molluscum contagiosum virus that most often affect children. The virus spreads through contact. Quite often it is infected through shared toys, household items, dishes and bed sheets. However, the agent can easily survive in an aquatic environment, and therefore often attacks children visiting the communal pool.

Another way of local spread is self-infection. A child who has several elements of skin rashes scratches them, spreading the infection to neighboring healthy ones. skin. This is how the scale of the damage increases. Molluscum contagiosum is contagious, and therefore a child who has been diagnosed with such an infectious disease should not attend kindergarten or school. Parents must notify the teacher and class teacher about the presence of illness.

IN children's team are introduced increased measures safety, the skin of other children is carefully examined by medical workers.

Incubation period ranges from 3 weeks to six months. The first signs of the disease can therefore only be detected after a considerable period of time. In newborns, the incubation period lasts less, and the dermatological disease manifests itself faster - after 2-3 weeks. The risk of infection for an infant is posed by parents who are sick with molluscum contagiosum, relatives and family friends who come to visit, and there is also a chance of getting the virus in the so-called vertical way - from mother to child during pregnancy.

Despite its scary name, this virus is not dangerous and does not threaten the life of a child. In most cases it doesn't even require specific treatment. However, situations are different, and sometimes the need for therapy still arises.

Causes of the disease

A child who is exposed to poxvirus (molluscum contagiosum virus) does not necessarily become infected with it. Most often, the disease occurs in children with insufficiently developed immunity.

At risk:

• children with HIV infection and other diseases associated with a deficiency of the immune system;
• children attending large children's groups;
• frequently ill children who are characterized by a certain immune “apathy”;
• children with dermatological and allergic diseases in the anamnesis;
• children who neglect to observe hygiene rules;
• children from six months of age, when babies are no longer protected by maternal innate immunity.

Molluscum contagiosum virus particles are enough for a long time can live in the environment, in dust, in the air. But they become active only after penetration into the liquid environment of the body. For them, this is the substance with which they are filled. skin rashes. Therefore, the risk of infection also exists if the child receives wounds, scratches, or abrasions.

Even after infection, the virus may not appear for a long time, and the first rashes usually coincide with other factors that indirectly “accelerate” the manifestations of molluscs on the skin.

These factors include:

• state severe stress or prolonged stress experienced by the child;
• previous acute viral or bacterial disease;
• negative external factors - inhalation and skin contact with toxins, carcinogens, allergens;
• food or drug poisoning.

The mechanisms and causes of action of the posquivirus have not yet been fully studied, and on many issues relating to this pathogen, doctors and scientists do not have a consensus, but almost all experts agree on one thing - a person with a strong, hardened immune system is ten times less likely to become infected with a contagious virus. shellfish, even with direct contact with it. But science is not yet able to explain why the virus can infect both the skin and be characterized by subcutaneous nodules.

Symptoms and signs

The main and almost only symptom of the disease is a skin rash. It has the character of individual papules. Each has a round or oval shape. Their size can be very small - from 1 mm in diameter, or significant - up to several centimeters.

On initial stage papules have a typical skin color and are almost invisible. But quite quickly the rashes become pink with an orange tint and acquire a pearly top. If you press on the top, thick white curdled discharge like from some pimples. Sometimes papules appearance resemble erythrocyte cells, “pancakes” of dense consistency. In the center of each such disc there is a small depression, reminiscent of a human navel.

At the very beginning of the disease, the papules are small. They expand quite quickly and can reach a diameter of 7-10 millimeters. If the mollusks reach a size of more than 2 centimeters, doctors talk about a giant form of the disease.

Quite rarely, papules are located at some elevation above the skin, on a small movable “leg”. Then the disease is called pedicular.

With numerous small papules, molluscum contagiosum is called miliary. The most common form is the usual one - when a child has 1-2 papules, sometimes their number reaches a dozen. In adults, MCV-1 and MCV-2 viruses most often appear on the thighs and genitals. In children, the “geography” of the third and fourth types of molluscum contagiosum virus is more extensive. Most often, the first papules appear on the skin of the face, body, arms and legs. Characteristic pink hemispherical formations are often located exclusively locally - only on the nose, head, neck, eyebrows and chin.

If a child begins to scratch, rub or squeeze out the papules, the infection will begin to spread further quite quickly - to the chest, back, stomach. On early stage the papules are quite hard and dense. Gradually they soften and become more loose. The rash does not cause pain. However, many children complain that the papules itch and itch.

The disease does not always require treatment, since molluscum contagiosum goes away on its own. True, this requires quite a lot of time - from several months to several years. Most often, the recovery process takes from six months to a year.

Papules do not leave any traces on the skin after recovery. Scars and depressions as consequences are more characteristic of the poxvirus's closest relative, the smallpox virus. However big size papules and extensive lesions, coupled with the child’s weakened immune system, may be good reasons for therapeutic measures.

Diagnostics

Any pediatrician is able to recognize molluscum contagiosum, as they say, by sight. Diagnosis even with an initial visual examination does not cause significant difficulties. By the appearance of the papules, by opening one of the papules manually, the correct diagnosis can be established.

Sometimes, to make sure of his assumption, the doctor will take the contents of one papule on laboratory analysis. In this white grainy mass in laboratory conditions usually reveal oval epithelial cells that have undergone significant degenerative effects. Inside these cells, protoplasmic inclusions are observed, which are called Lipschutz mollusks.

If such cells microscopic examination the contents of the papules will not be detected, the doctor will reconsider the diagnosis and examine the child for warts, pimples, scabies, and keratoacanthoma.

No other additional tests or studies are required for molluscum contagiosum. Once the diagnosis is confirmed, the child will be sent for a consultation with a pediatric dermatologist who will be able to answer main question- Is it necessary to treat the baby or is it better to wait until the disease goes away on its own.

Treatment

As already mentioned, molluscum contagiosum can go away on its own, however, you will have to wait quite a long time. Doctors do not agree to this if the child has an immunodeficiency (HIV and other pathologies of the immune system), if he has a serious concomitant infectious disease, and also if the papules are located on the eyelids or genitals. Parents sometimes do not agree to wait for months, especially if the molluscum contagiosum papules are located in a visible place - on the face, nose, eyes, or hands of the child.

In all these cases, they are offered a wide variety of ways to treat the disease. To be more precise, there is no way to treat the mollusk, you can only eliminate it cosmetic defects- the papules themselves. However, before complete self-healing, the appearance of new elements in a child under unfavorable circumstances is quite possible. Immunity to the virus is developed, but this happens very slowly. If with an acute respiratory viral infection 3-5 days are enough for the body to take control of the situation “into its own hands” and suppress the virus, then with molluscum contagiosum the period for developing immunity is calculated in months and even years.

If the doctor claims that there is no need to treat the child, and the parents want to rid the baby of papules, then no one will interfere with them, and the doctor will recommend one of the treatment options.

Curettage

This method should not be carried out at home on your own; it is advisable to undergo the procedure in a sterile clinic environment. The temptation to do everything at home with your own hands is great, because the procedure is quite simple. But the consequences of home treatment can be sad - this is, first of all, infection.

The method involves removing the head with tweezers and scraping out the papules with a curette or a special instrument - Volkmann spoon. When the papule cavity becomes clean, it is cauterized with iodine. Sometimes the doctor limits himself only to thin tweezers; for small rashes this is quite enough.

This method has more disadvantages than advantages. Judge for yourself - the procedure is quite painful and unpleasant. For a child, even with the external use of a spray with an anesthetic effect (“ Lidocaine", for example), it will be quite difficult to withstand the curettage to the end. This method is absolutely not suitable for removing papules located on the face, especially in the eye area, since after curettage there is a risk of small local bleeding, and sunken deep scars often remain on the skin.

Parents who, in numerous reviews on the Internet, advise not to spend money on cosmetic procedures, and doing all this at home, risks doubly - in addition to the possibility of skin defects, there is added the possibility of infecting the child with pathogenic bacteria.

Cryodestruction

It is quite possible to remove molluscum contagiosum papules with liquid nitrogen or dry ice. Almost any clinic offers this procedure. Papules are destroyed quite quickly under the influence of liquid nitrogen; the procedure is painless and does not require anesthesia. True, according to patient reviews, it still causes some quite tolerable discomfort.

The substance is kept on the area affected by molluscum contagiosum for no more than 20 seconds, after which the surface is treated with an antiseptic. In this case, manipulation can be carried out either by hardware or by swab (manual) method. An area exposed to dry ice or liquid nitrogen will temporarily show all classic signs thermal damage - it turns white, swelling appears around the cauterization site, which can last about 3-4 hours.

Then a small bubble forms around the frozen papule, which absolutely cannot be pierced, so as not to infect the child. The frostbitten papule itself is rejected after about a month and a half. This method is not considered the most successful for getting rid of molluscum contagiosum on the face and all exposed parts of the body. Blisters that occur under the influence of cold often leave marks on the skin in the form of small scars even after recovery.

In addition, in childhood it is often observed allergic reaction to the cold. To avoid such consequences, it is advisable to undergo a test for such an allergy in advance and begin cryodestruction only when the child is allowed this intervention.

Electrocoagulation

This method is based on cauterization of molluscum contagiosum papules with high-frequency electrical alternating current. Under the influence of current, the surface of the skin and the papule heat up, the mollusk dies, and in its place a small crust forms, which itself comes off after a week or a week and a half. The procedure is carried out special device electrocoagulator. The skin is first anesthetized. After cauterization, the former papules are treated with iodine or another antiseptic. The result is assessed after a week. The disadvantage of the method is that not all papules may die. Sometimes the procedure has to be repeated.

Laser treatment

To date, this method is considered the safest and most effective. In a clinical setting, papules are targeted with a pulsed laser, after numbing the skin with an anesthetic in the form of a cream. The affected area of ​​skin under laser beam warms up to 150-155 degrees. At this temperature, the virus dies and the contents of the papules evaporate. High temperature also completely disinfects the affected area, which eliminates infection by bacteria and fungi.

You won't have to wait long for the effect. After the first laser therapy session, about 90% of molluscum contagiosum papules die. Most often, one session is enough to completely defeat the disease. In place of the semicircular spherical papules after laser exposure, reddened spots remain, which usually disappear quite quickly.

The therapy does not leave scars, depressions or other defects, which is why the method is considered the most suitable for removing mollusks from a child’s skin if they are located on the face, near the eyes, on the nose, or chin.

After such exposure, you should not wet the areas that were exposed to laser beams for three days. The child should not visit the swimming pool, bathhouse, shower, or sauna. After three days you can return to ordinary life. The disadvantage of laser therapy is that it is contraindicated for newborns and children with other skin diseases - microbial, fungal or allergic in origin.

Medications

To treat molluscum contagiosum, the method of chemical cauterization of papules is used. It should be understood that skin rashes with this disease are of viral origin, and therefore they are completely insensitive to alcohol-based antiseptics and “green stuff”. All drying agents can also be dangerous, since drying papules is strictly prohibited.

Other medicines used include:

• Antiseptics are often used " Fukortsin" It allows you to stop the spread of infection, especially if the child constantly scratches, injures and tears off the papules. Lotion " Molyustin", although it is not medicine, but belongs to the category of cosmetic preparations, leads to the destruction of cells affected by the virus and quite effectively gets rid of papules, but it can only be used for children over 3 years old.

• Good help medicinal ointments containing tretinoin. This " Vesanoid», « Lokacid" These drugs are not prohibited for use in childhood, but the results are sufficient and convincing clinical trials Manufacturers do not have any for children. Before use, be sure to consult a doctor. If he approves, then the ointment is applied to the papules twice a day for at least 5-6 hours, after which the affected skin is washed warm water with soap. The procedures are continued until the last papule completely disappears.
• Non-protein poison cantharidin, which underlies this known drug, How " Spanish fly", is also quite often used to treat molluscum contagiosum. However, you need to be extremely careful with this remedy, because this poison can cause severe poisoning. For children under 7 years of age, be sure to consult a doctor.
• Cream " Imiquimod", which is often advised to be used for molluscum contagiosum, does not have antiviral activity, and it is not advisable for children under 18 years of age to use it. It's better to give preference oxolinic ointment. This drug is applied to the papules in a thick layer 2-3 times a day.

Taking antibiotics for molluscum contagiosum is not advisable because antimicrobials have no effect on the virus at all. In rare cases, the doctor may recommend an antibiotic ointment, but only if the child has a bacterial infection, and some previously injured papules have begun to fester and become inflamed.

Traditional methods of treatment are based on lubrication of papules garlic juice, calendula tincture, string infusion and bird cherry juice. However, experts do not recommend self-medication, since papules are easy to damage, and in a lack of sterility, the risk of infection will increase many times over. Recovery is considered the period when the last mollusk on the child’s skin has disappeared.

Immunity is not lifelong, and reinfection may occur after some time.

Prevention

The best prevention Molluscum contagiosum is by following the rules of hygiene. It is important that the child from the very early age I learned to use only my own towel, brush, and slippers. Underwear should be changed daily, and bed linen should be changed once a week. If the child goes to the pool and swims or visits with parents public bath, It is important that after each such visit he takes a shower and changes into clean clothes.

If there are several children in a family, then the person with molluscum contagiosum is transferred to a somewhat isolated state. It is clear that a child cannot be limited in communication for a whole year until all his papules disappear. But it is quite enough to avoid close physical contact, as well as sharing the same toys, dishes, towels and bed linen. For the patient, all this should be personal.

One of the main points in the prevention of molluscum contagiosum is to strengthen children's immunity. From a very early age, it is necessary to harden the child, provide long walks on fresh air. At an older age, playing sports is encouraged. Nutrition should be balanced and full of everything essential vitamins. During periods of mass incidence of viral respiratory infections, it is better to refrain from visiting public places with large crowds of people with your child, from traveling to public transport during rush hour, from visiting clinics and hospitals unless absolutely necessary. Helps strengthen the immune system preventive vaccinations, which are provided National calendar vaccinations.

You should not refuse them, since vaccines are also training for the immune system, which will not allow the child to become infected dangerous illnesses, and will also reduce the overall seasonal incidence of ARVI.

To learn about what molluscum contagiosum is and how to fight it, see the following video.

Molluscum contagiosum is a fairly common viral skin disease that occurs primarily in childhood (usually preschool age). The causative agent of molluscum contagiosum is the molluscum contagiosum virus, which is pathogenic exclusively for human body and has a certain resemblance to the smallpox virus.

Quite often, patients with this dermatological disease, due to abrasion or complete absence symptoms do not go to the doctor, as a result of which molluscum contagiosum becomes chronic.

What it is?

Molluscum contagiosum is an infectious disease caused by the smallpox virus that affects the skin and sometimes mucous membranes. Typical manifestations of the rash are erythematous, dense, shiny nodules. Treatment of the disease is mandatory, provided that the disease does not pose a threat to human life and health.

How can you get infected?

Molluscum contagiosum is most often transmitted by contact and by everyday means, it can lead to outbreaks in children's groups and damage to family members. The virus is transmitted through direct contact with a sick person, as well as through contaminated household items, clothing, water in a pool or natural reservoirs, and toys.

In the environment, the virus is quite stable and can persist in the dust of residential premises and gyms, infecting more and more people. In adults, the disease can occur after tattooing if the pathogen remains on the instruments used by the artist.

Penetration of the pathogen occurs through microdamage to the skin. Therefore, the risk of infection increases if there is dermatological diseases with itching, dryness or weeping of the skin, disruption of the integrity of the epidermis. In women, the molluscum contagiosum virus often penetrates through the mucous membrane of the genital organs and the skin of the perineum. Moreover, to transmit the infection from a partner, sexual intercourse itself is not required; only contact with the affected skin areas is necessary. Therefore, although infection with molluscum contagiosum in adults is often associated with sexual contact, it is incorrect to classify it as a true STD.

Pathogen

The virus affects only humans, is not transmitted by animals and is close to smallpox viruses. There are 4 types of molluscum contagiosum virus (MCV-1, MCV-2, MCV-3, MCV-4). Of these, MCV-1 is the most common, while MCV-2 usually appears in adults and is often sexually transmitted. Can also be transmitted through water (eg swimming pool). Inside the formation there is a liquid through which it is transported and multiplies.

Molluscum contagiosum is caused by a virus (molluscum contagiosum virus), which is part of the poxvirus group. This virus spreads from person to person through direct contact and is most common in children. In addition, it can be infected through sexual intercourse; people with impaired immune system functioning are most susceptible to the virus. Molluscum contagiosum can spread by scratching or rubbing the affected skin.

Skin lesions of molluscum contagiosum are sometimes confused with lesions caused by the acrochordona virus.

Molluscum contagiosum during pregnancy

During pregnancy, against the background of a natural decrease in immunity, activation of an existing infection or a fresh infection with molluscum contagiosum may occur. The clinical picture has no peculiarities. The molluscum contagiosum virus does not pose a danger to the fetus, but during childbirth and subsequent contact with the mother's skin, the child can become infected.

Treatment must be carried out immediately after detection of the disease, taking into account contraindications for some procedures. Shortly before birth, a repeat examination is carried out even in the absence of complaints. This is necessary to identify possible recurrent rashes on the genitals and areas of the skin that are inaccessible for self-examination.

Symptoms and photos

Most often, papules, which are direct signs of molluscum contagiosum (see photo), are localized in children on the face, torso and limbs, in adults - in the genital area, on the stomach and inner thighs.

Most often papules:

• small size (from 2 to 5 mm in diameter);
• don't call pain, but are sometimes accompanied by itching;
• have a dimple in the center;
• have a core of white, waxy material;
• At first they are dense, dome-shaped, flesh-colored, and become softer over time.

Molluscum contagiosum usually goes away spontaneously in people with normal immune systems after several months or years. In people with AIDS or other diseases that affect the immune system, damage associated with exposure to molluscum contagiosum may be more extensive.

Diagnostics

In the classic form, the diagnosis of molluscum contagiosum is easy to make. Taken into account: childhood, the presence of children with molluscum in the team, multiple spherical formations on the skin with an umbilical depression.

Difficulties in diagnosis rarely arise when atypical forms. But even with atypical appearances, dermatoscopy clearly shows umbilical depressions in the center of the molluscan papules.

Differential diagnosis of molluscum contagiosum is carried out with the following diseases:

• pyoderma (ulcers on the skin),
• chickenpox (chickenpox),
• filamentous papillomas (read a detailed article about filamentous papillomas),
• vulgar warts (read about vulgar warts),
• genital warts on the genitals (read about genital warts),
• milia.

IN difficult cases The doctor resorts to squeezing the papule with tweezers. If crumbly masses are squeezed out of the papule, with a 99% probability it is molluscum contagiosum.

In even rarer cases, they resort to diagnosis under a microscope. To do this, the crumb-like masses are sent to the laboratory, where a picture corresponding to this disease. In this case, eosinophilic inclusions are found in the cytoplasm of the cells.

Could there be complications?

The development of molluscum contagiosum in the normal course does not lead to the formation of any problems over time, and often the elements can gradually disappear from the skin without leaving any traces on it. This can happen even without treatment for about three to four years.

• Some treatments may cause scarring on the skin.
• Sometimes the infection can reactivate, in which case a larger area of ​​skin is affected.
• In the presence of severely weakened immunity, the development of molluscum contagiosum can take a generalized and pronounced form.

When the elements appear abundantly on the face and body, or become large sizes, may change in appearance - treatment becomes difficult. In such cases, active therapy with drugs, both local and to stimulate systemic immunity, is indicated.

Treatment of molluscum contagiosum

Currently, molluscum contagiosum in women, unless the nodules are localized on the eyelids or in the genital area, is recommended not to be treated at all, since after 3 to 18 months the immune system will be able to suppress the activity of the orthopoxvirus, and all formations will disappear on their own, leaving no traces on the skin any traces (scars, scars, etc.).

The fact is that immunity to the molluscum contagiosum virus is developed, but this happens slowly, so the body needs not a week to heal itself from the infection, as in the case of ARVI, but several months or even up to 2 - 5 years. And if you remove the nodules of molluscum contagiosum before they disappear on their own, then, firstly, you can leave scars on the skin, and secondly, this increases the risk of them reappearance, and in even larger quantities, since the virus is still active. Therefore, given that self-healing always occurs, and it is only a matter of time, doctors recommend not treating molluscum contagiosum by removing the nodules, but simply waiting a little until they disappear on their own.

The only situations when it is still recommended to remove nodules of molluscum contagiosum are their localization on the genitals or eyelids, as well as severe discomfort caused by the formation to a person. In other cases, it is better to leave the nodules and wait for them to disappear on their own after the activity of the virus is suppressed by the immune system.

Removal of molluscum contagiosum

If a person wants to remove the nodules, then this is done. Moreover, the reason for such a desire, as a rule, is aesthetic considerations. For the removal of molluscum contagiosum nodules, the following surgical methods have been officially approved by the Ministries of Health of the CIS countries:

1. Cryodestruction (destruction of nodules with liquid nitrogen);
2. Curettage (scraping out nodules with a curette or Volkmann spoon);
3. Laser destruction (destruction of nodules with CO2 laser);
4. Electrocoagulation (destruction of nodules by electric current - “cauterization”);
5. Husking (removing the core of nodules with thin tweezers).

In practice, in addition to these officially approved methods for removing molluscum contagiosum nodules, other methods are used. These methods involve influencing the nodules of molluscum contagiosum with various chemicals in the composition of ointments and solutions that can destroy the structure of formations. Thus, currently ointments and solutions containing tretinoin, cantharidin, trichloroacetic acid, salicylic acid, imiquimod, podophyllotoxin, chlorophyllipt, fluorouracil, oxoline, benzoyl peroxide, as well as interferons alpha-2a and alpha-2b.

Such chemical methods for removing shellfish cannot be called traditional methods, since they involve the use medicines, as a result of which they are considered to be unofficial, practice-tested methods, but not approved by the Ministries of Health. Since these methods, according to reviews from doctors and patients, are quite effective and less traumatic compared to surgical methods for removing molluscum contagiosum nodules, we will also consider them in the subsection below.

Folk remedies

Most effective means for the treatment of the disease in question from the category “traditional medicine”:

1. Prepare a concentrated solution of potassium permanganate - it should be dark purple. It is soaked in cotton swab and apply (cauterize) to the papule. Please note that after using potassium permanganate, burns may form on the skin - be extremely careful, treat the papule specifically, acting on it point by point.
2. The string grass is crushed and a decoction is made - 300 ml of water per 100 grams of raw material, cook for 3 minutes. Then the broth should brew for 60-90 minutes. Only after this can you strain it through a strainer or several layers of gauze. A decoction of the string is used as a lotion and for wiping off papules. There are no restrictions on the number of procedures per day.
3. Grind a few cloves of garlic (in a blender or on fine grater), add 30-50 grams of butter (soft) to them and mix everything thoroughly until a paste-like mixture is obtained. The product must be applied to the affected areas of the skin 2 times a day. Please note that garlic can cause burning and even irritation on healthy areas of the skin, so try to use this product with extreme caution.

You can also use some plants that will help get rid of papules in a short time. For example, the juice from bird cherry leaves copes with this task perfectly (it is squeezed out and stored in a cool, dark place) - a cotton pad is moistened in it and the skin is treated after removing the nodules. Moreover, this remedy can be used for a long period, until all wounds are completely healed.

Prevention

Preventive actions:

• examination of children in schools and kindergartens in order to prevent the spread of molluscum contagiosum;
• early detection of the disease;
• isolation of the patient from the team during treatment;
• regular wet cleaning of premises to eliminate dust containing viral particles;
• examination of co-residents and team members for the presence of papules;
• daily change of underwear;
• strictly personal use of personal hygiene items;
• selectivity when choosing sexual partners;
• mandatory shower after visiting the bathhouse, sauna, swimming in the pool and after sexual intercourse;
• patients are contraindicated from visiting massage rooms, swimming pools, saunas for the period of treatment;
• It is forbidden to comb papules; after accidental injury, treat the damage with an antiseptic;
• if papules are localized on the face, do not use harsh scrubs; men should be careful when shaving;
• isolation of the patient and the objects he uses within the family;
• strengthening the immune system (hardening, moderate physical exercise, walks in the fresh air, swimming).

In the vast majority of cases, with molluscum contagiosum, the prognosis is favorable. The disease has virtually no complications and is easy to treat. The prognosis is significantly aggravated by the state of immunodeficiency, against which generalized forms of the disease develop with large formations that cannot be treated.

The disease molluscum contagiosum was first described in 1817, and in 1841 it was proven infectious origin. The pathology got its name due to the shape of the nodules, which, under high magnification, resemble a snail shell. The virus exclusively affects people, but according to some data, animals and birds can act as carriers of it.

Molluscum contagiosum most often occurs in children aged 2 to 10 years through close contact or shared use of contaminated objects, so the disease is typical for children's groups.

Among the adult population, the infection is mainly spread through sexual contact. Particularly susceptible to molluscum contagiosum persons with reduced immunity. 15-18% of immunodeficiency virus carriers exhibit symptoms of molluscum contagiosum.

Epidemic outbreaks and sporadic cases occur periodically throughout the world. The disease is characterized by a benign course and disappears spontaneously after 6-12 months, so treatment is not always advisable.

CAUSES

The causative agent of molluscum contagiosum is the Molitorhominis virus, which is close to the causative agent of smallpox. Its structure is heterogeneous; there are 4 types of virus: MCV1, MCV2, MCV3, MCV4. The most common pathogens are MCV1 and MCV2.

Routes of infection:

• Contact - indirectly through household means through water, personal hygiene items and through contact with a virus carrier or patient (direct contact). The source of infection can be toys, underwear and personal belongings of the patient.
• Sexual - typical for distribution among the adult population.

Molluscum contagiosum is not classified as venereal diseases, but according to the WHO classification it is defined as a disease sexually transmitted. In addition, there is currently information about the transmission of the virus through blood.

Predisposing factors:

• visiting public places (swimming pool, bathhouse, sauna, cosmetologist’s or massage therapist’s office);
• close contact with a carrier of infection;
• skin damage;
• failure to comply with room cleanliness standards;
• decreased immunity;
• tendency to allergic reactions;
• taking hormonal and cytostatic drugs;
• promiscuous sex life.

At-risk groups:

• children's age from 2 to 10 years;
• elderly people over 60 years of age;
• massage therapists;
• swimming coaches;
• medical staff of medical institutions of junior and middle level.

Children under one year of age are resistant to the virus due to the immunity received from the mother.

The causative agent of molluscum contagiosum lives outside the body, settles with dust, remains on the surface of furniture and carpets, and therefore becomes a cause of infection in kindergartens, schools and within families.

The virus exhibits tropism for integumentary tissues skin and multiplies in the cytoplasm of their cells, since antibodies to its antigen circulate in the human blood. Virus replication begins in keratinocytes, and it blocks T-lymphocytes, which explains the immune system's tolerance to it.

The pathogen increases the rate of division of these cells, and convex neoplasms in the form of papules appear at this site. Inside the nodules there is infectious viral material, which, when damaged, enters the environment and can infect others.

CLASSIFICATION

Forms of molluscum contagiosum:

• miliary;
• pedicular;
• classical;
• gigantic.

SYMPTOMS

From the moment of molluscum contagiosum to the appearance of formations, it takes from two weeks to several months. At the site of the virus introduction is being formed pink spot, later papules appear here, which are the main symptom of molluscum.

In children they are localized on the face, arms, legs and torso; in adults, as a rule, they occur with inside thighs, abdomen and genital area. If for children the localization of papules on the face is considered typical, then if similar symptoms are detected in adults, the presence of acquired immunodeficiency is assumed. In HIV-positive individuals, papules are numerous, can reach 3 cm and are not amenable to therapy; the severity of the disease depends on the depth of immunosuppression.

Elements of the rash can be found on the scalp, tongue, lips, and mucous membranes of the cheeks. An atypical localization of papules is their location on the soles of the feet.

Features of molluscum contagiosum papules:

• hemispherical formations rising above the skin;
• the color is often the same as the skin, may be slightly reddened;
• the surface is shiny, sometimes with a pearlescent sheen;
• size from 1 to 10 mm;
• single or multiple;
• do not cause pain;
• sometimes accompanied by itching;
• have a depression in the center;
• when they appear, they are dense, but later become soft to the touch;
• inside the papules there is a white waxy content;
• the addition of a secondary infection is accompanied by redness, suppuration and swelling in the area of ​​the rash.

With normal immunity, papules do not cause concern and disappear within six months, so the dermatologist is selective in prescribing treatment.

DIAGNOSTICS

For correct diagnosis often happens it is enough to examine the clinical manifestations molluscum contagiosum.

Papules tend to develop bacterial infection, which is why the picture of molluscum contagiosum can change significantly. In doubtful situations, a dermatologist may resort to a biopsy and microscopic examination of the papules or their contents. As a result of studying tissues, eosinophilic inclusions (mollusc bodies) are identified in the cytoplasm of keratinocytes.

Differential diagnosis is required to exclude a number of diseases with similar symptoms.

Differential diagnosis:

• lichen planus;
• human papillomavirus infection;
• keratoacanthomas;
• syphilitic papules;
• pyoderma;
• warts

Molluscum contagiosum is a common companion to HIV, so when it is detected, a test for human immunodeficiency virus is performed.

TREATMENT

Molluscum contagiosum does not require mandatory treatment. The appropriateness of therapy is determined by a dermatologist. Treatment held in outpatient setting . Self-medication can lead to worsening of the condition.

If you refuse medical care it is impossible to detect malignant and benign neoplasms, which in appearance resemble molluscum papules, and also conduct an examination for HIV infection.

Indications for the treatment of molluscum contagiosum:

• decreased immunity;
• no regression of rashes;
• frequent traumatization of papules.

When prescribing treatment, the stage of the disease, its severity and the patient’s immunity status are taken into account.

Treatment methods:

• Mechanical removal of papules - squeezing out and then curettage with a sharp Volkmann spoon and antiseptic treatment iodine or more gentle antiseptics for children. Local anesthesia with an anesthetic spray or freezing with liquid nitrogen is first recommended. This method does not leave marks on the skin in the form of scars.
• Cauterization (diathermocoagulation) and laser destruction can leave scars and are therefore undesirable for this diagnosis.
• Taking immunomodulators, using antiviral ointments.
• Prescribing antibiotics for the development of generalized (with the appearance of many papules) forms of the disease.
• Keratolytics for the destruction of formations are applied dropwise to each papule daily until it is completely rejected.
• Tuberculin application is used in pediatric dermatology in the treatment of children vaccinated with BCG.
• General strengthening procedures.

Before starting treatment, the patient’s personal belongings can be disinfected, and after some time, family members should be examined for the presence of papules. In cases of sexual transmission, partners are subject to mandatory treatment. Sexual intercourse is stopped during treatment.

As in the case of other DNA-containing viruses, it is quite difficult to completely get rid of the causative agent of molluscum contagiosum, so molluscum contagiosum is chronic and can recur. General strengthening The body's defenses help prevent recurrence of symptoms.

COMPLICATIONS

Molluscum contagiosum does not pose a health threat. Even without treatment, the disease leads to complications in extremely rare cases.

Possible complications:

• Development of secondary infection bacterial origin with skin inflammation and suppuration, after treatment of which scarring may remain.
• A widespread rash with large elements several centimeters in size is most often a signal of severe immunodeficiency.

PREVENTION

Preventive actions:

• early detection of the disease;
• isolation of the patient from the team during treatment;
• examination of children in schools and kindergartens in order to prevent the spread of molluscum contagiosum;
• examination of co-residents and team members for the presence of papules;
• daily change of underwear;
• regular wet cleaning of premises to eliminate dust containing viral particles;
• mandatory shower after visiting the bathhouse, sauna, swimming in the pool and after sexual intercourse;
• patients are contraindicated from visiting massage rooms, swimming pools, saunas for the period of treatment;
• strictly personal use of personal hygiene items;
• selectivity when choosing sexual partners;
• isolation of the patient and the objects he uses within the family;
• strengthening the immune system (hardening, moderate physical activity, walking in the fresh air, swimming);
• It is forbidden to comb papules; after accidental injury, treat the damage with an antiseptic;
• If papules are localized on the face, do not use harsh scrubs; men should be careful when shaving.

  PROGNOSIS FOR RECOVERY

  In the vast majority of cases, with molluscum contagiosum, the prognosis is favorable. The disease has virtually no complications and is easy to treat. The prognosis is significantly aggravated by the state of immunodeficiency, against which generalized forms of the disease develop with large formations that cannot be treated.

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