Molluscum Contagiosum After First Sexual Contact

August 4, 2010

These asymptomatic bumps that developed on the groin area of a 16-year-old girl after her first sexual exposure are molluscum contagiosum. Central umbiliication distinguishes these lesions from warts.

Case 2:

These asymptomatic bumps developed on the groin area of a 16-year-old girl after her first sexual exposure.

Answer on Next Page

Case 2: Molluscum contagiosum

This teenager had contracted molluscum contagiosum,B, a viral infection that can resemble warts. On close inspection, each lesion has a central umbilication, which distinguishes it from a wart.

HPV infection in women can cause genital warts, which should be considered in the differential. Bacterial folliculitis is typically tender and pustular. A milium appears as a deep whitehead–type comedone.

Molluscum contagiosum has 2 peaks of incidence¹:

•	The first is in children, in whom transmission occurs from nonsexual skin contact.
•	The second is in young adults (aged 15 to 29 years), in whom the infection is usually sexually transmitted.

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Topical treatments include the following:

•	Cantharidin: A single application that may need to be repeated once or twice every 3 to 4 weeks.
•	Tretinoin cream (0.1%) or gel (0.025%): Applied daily until the lesions resolve.
•	Imiquimod cream 5%: Applied daily until the lesions resolve.
•	Trichloroacetic acid: A single application that can be repeated at 3 to 4 weeks as needed.
•	Cryotherapy with liquid nitrogen.

References:

REFERENCE:1. Pannell RS, Fleming DM, Cross KW. The incidence of molluscum contagiosum, scabies and lichen planus. Epidemiol Infect. 2005;133:985-991.

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