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. |
Poll Results
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. |
