Molluscum Contagiosum in Africa

Africa has a warm tropical climate. Researchers have observed that molluscum contagiosum is more prevalent in warm climates with lightly dressed children. In Mali, the disease is among the common dermatoses in children.

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According to Medscape,  child molluscum is prevalent in some regions of Africa like Papua New Guinea. More than 52% of children over two years and 17% of an entire village population in the East Africa region suffered from lesions that resulted from a molluscum contagiosum outbreak. Scientists attributed the outbreak to the warm climate and poor hygiene conditions.

What is molluscum contagiosum?

Molluscum contagiosum is a viral skin infection caused by a poxvirus (of the Molluscipox Virus genus).  The infection results in the formation of round, smooth pearly lesions that occur anywhere on the body. 

The lesions appear mostly on the neck, face, genitals, legs, and abdomen either in groups or alone. It can last for six to twelve months and as long as four years. In children, it’s a minor problem but unsightly. It’s serious about adults and immunocompromised people like those with HIV

Symptoms of molluscum contagiosum

Molluscum contagiosum appear as pink, white, fresh-colored lesions with a pit in the center. They’re also pearly, painless, with a size ranging from 2 to 5 millimeters. They cluster, or appear alone anywhere it affects the body. May appear on hands, armpits, face, and any other place that can facilitate skin to a skin infection. Sexually transmitted Molluscum contagiosum appears on genitals, upper thighs, and lower abdomen.

Transmission of molluscum contagiosum

As the name suggests, molluscum contagiosum gets spread highly by skin contact with an infected person. Lesions in the genital area occur because of sexual contact. Swimming in a pool contaminated with the virus can facilitate transmission. The more exposure to the virus, the more chances of developing Mollusca. 

Effect of molluscum contagiosum in people with HIV/Aids?

Immunocompromised people like those with HIV/AIDS are extremely at risk of contracting an infection from molluscum contagiosum. The lesions are more in number and larger and take significantly longer to heal in people with HIV/AIDS. 

Diagnosis of molluscum contagiosum

Diagnosis of molluscum contagiosum can either be done by conducting a biopsy of the cells from lesions or by observing characteristics of the nodules as the molluscum contagiosum has identifiable specific characteristics. 

Molluscum contagiosum treatment 

Treatment of contagious molluscum infection is usually unnecessary because it can go away in immunocompetent people. However, treatment is highly recommended when its larger, numerous, and appears in an awkward place and especially for immunocompromised people.

Treatment involves:

Immunocompromised therapy

Those people with HIV/AIDS and other conditions that are immunosuppressant are prescribed with immune-boosting therapies and Antiretroviral drugs. Intralesional interferon has been used despite its undesirable side effects but has been observed to work well in healthy people. 

Topical treatment

Iodine, podophyllotoxin cream, salicylic acid, cantharidin, and tretinoin. Podophyllotoxin is recommended for men, rather than pregnant women, because of its toxic effects on the fetus.

Oral treatment

Oral treatment usually applies to pediatric patients who are afraid of the pain associated with pricking or squeezing the lesions. Oral cimetidine is painless, safe, and can be administered by parents at home.

Physical removal

This technique is painful and mostly done on adults. It’s inadvisable to do it by yourself because you may infect other parts of the body or risk spreading to others. 

Curettage (removal by piercing and scrapping off the cheesy part), cryotherapy (freezing the nodules by using nitrogen), and use of laser therapy are among the physical methods of molluscum contagiosum lesions.

Prognosis of Molluscum contagiosum

Molluscum lesions are more persistent in people with immunocompromised systems, while in healthy people, they disappear after 6-12 months on their own.  If the lesions aren’t treated earlier,  it might take up to 5 years to get rid of it. Early treatment helps in getting it under control and by stopping its spread.  About 35% of healed patients got re-infected with the virus. Reasons for recurrence are yet unknown.

References

https://pubmed.ncbi.nlm.nih.gov/8641888/

https://pubmed.ncbi.nlm.nih.gov/12639455/

https://emedicine.medscape.com/article/910570-overview#a3

https://www.webmd.com/skin-problems-and-treatments/guide/molluscum-contagium

https://www.cdc.gov/poxvirus/molluscum-contagiosum/treatment.html

https://www.aad.org/public/diseases/a-z/molluscum-contagiosum-treatment

https://dermnetnz.org/topics/molluscum-contagiosum/

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