Molluscum contagiosum is a common poxvirus skin infection that causes small, painless, dome-shaped bumps, mostly in children. It spreads by skin contact and shared towels, and in healthy people it clears on its own within months to a couple of years.
Key symptoms
- Small painless skin-colored or pearly bumps
- Clusters on the trunk, arms, legs or face in children
- Bumps in the genital area in sexually active adults
- Mild itch or an eczema-like rash around the bumps
What you find on exam
- Firm dome-shaped bumps 2 to 5 mm with a central dimple (umbilication)
- A white cheesy core can sometimes be pressed out
- Red, swollen bumps before they clear (BOTE sign), not a bacterial infection
- Number and location of lesions; check for eczema
Tests
- Diagnosis is clinical
- Dermatoscope or biopsy if the diagnosis is unclear
- STI and HIV testing in adults with genital lesions or many large lesions
Treatment basics
- Watchful waiting is reasonable in healthy children
- Cryotherapy or curettage for a few lesions in older children and adults
- Topical cantharidin or berdazimer gel
- Treat nearby eczema; avoid scratching, picking or shaving the area
- No sharing towels or baths; cover lesions for swimming and contact sports
Red flags
- Many large lesions in an adult (possible weak immunity)
- Genital lesions in a young child (assess for abuse)
- Painful spreading redness with fever (true bacterial infection)
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.