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Molluscum Contagiosum Molluscum contagiosum (MC), often called “the clam” in Thailand, is a viral skin infection which produces small, firm, raised spots or eruptions on the skin forming in little clustered lesions. These are usually painless, but some reports mild to mederate itchiness. The infection is not serious and can clear up without any treatment, but the lesions can be annoying unattractive. This disease is confined to the skin and the mucous membranes. It is transmitted through direct skin contact with an infected person. The infection is actually a worldwide endemic, and has a higher incidence in children, sexually active adults and those who are immuno-deficient. It is prevalent in Thailand as a sexually transmitted disease. Another factor may be the tropical climate and the living conditions (overcrowding, poor hygiene, etc.). Causes “The Clam” is caused by the molluscum contagiosum virus and is transmitted through direct skin contact. Handling objects that has come in contact with the infection, also called formites, is also one of the reasons for transmission. There are four types of the virus, MCV-1 to -4. MCV-1 is the most prevalent while MCV-2 is seen usually in adults and often sexually transmitted. MCV-2 is the most common type found in Thailand. The average time of incubation and appearance of lesions is 2-7 weeks and can stretch up to 6 months. Signs and Symptoms MCV lesions appear to be smooth and dome-shapes and are generally skin-colored with opalescent character. They are not painful, but sometimes itchy and easily irritated. Scratching of the lesions can cause to eruption which may lead to infection and scarring. The center of the lesion that appears waxy and depressed contains the virus. The size of the lesion may vary depending on the stage of development, but usually averages 2-6 mm. The infection is limited to a localized area of the topmost layer of the skin, but sometimes it can develop on neighboring skin areas as well. This is called autoinoculation and children are more susceptible to this. The virus mostly affects the trunk of the body, arms, and legs. For sexually-transmitted MCV, it affects the groin, genital area, thighs and lower abdomen. Diagnosis The diagnosis for molluscum contagiosum is clinical appearance. The virus cannot be cultures in the laboratory although the diagnosis can be confirmed through excisional biopsy. Treatment Molluscum cantagiosum is a self-limited disease. The lesions can generally last from 2-3 months and may disappear on their own. Considering the high possibility of autoinoculation, it is best seek medical attention in order to control the spread of the virus. Treatment is often unnecessary but due to inoculation, it is highly considered by many. It should be noted though that treatments means to traumatize the lesions, which can leave pigmentary alterations or scarring. Some treatments for MCV available in Thailand include: Cryosurgery – Apply liquid nitrogen (dry ice) to each individual lesion. Repeat treatments in 2-3 weeks interval. Podophyllotoxin – Apply 15% (Indian podophyllum) or up to 25% solution (American podophyllum) on the warts once a week. Leave for 1-6 hr then wash off. Stop the treatment if no improvement is observed after 6 weeks. Alternatively, apply 0.5% alcoholic gel or 0.15% cream two times a day for 3 days but do not wash off. Repeat for up to 5 weeks. Salicylic Acid – After cleaning the area, apply 60% solution directly then cover with plaster. Repeat the process until lesions become soft which will be about 3-7 days. Imiquimod – As 5% cream, apply 3 times weekly for 4 weeks. The cream is applied at night and left on the skin for approximately 8 hours then wash off with mild soap and water. If no improvement is observed, a 4 week interval is needed before starting again on a 4 week treatment. For more information and Cure we recommend these books Sexually Transmitted Diseases in Thailand The Complete Guide to Natural Remedies for STD STI Available for free download on Kindle Prime Other STD Threads on Personal Thailand Hiv In Thailand Trichomoniasis in Thailand Syphilis in Thailand Non Specific Urethritis in Thailand Genital Warts in Thailand Herpes in Thailand Gonorrhea in Thailand Chlamydia in Thailand STD from Ladyboy Thailand
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Molluscum contagiosum – uzroci, simptomi i liječenje Molluscum contagiosum ili zarazni molusk je bezopasna virusna infekcija kože ili sluznice. Često se naziva i „vodenim bradavicama“. Pripada skupini spolno prenosivih bolest, a iako nije klasična spolno prenosiva bolest, spolni put prijenosa jedan je od češćih. Uzročnik je DNA poksvirus koji se naziva Molluscum contagiosum virus (MCV) i može inficirati samo ljude. Postoje četiri tipa MCV-a: MCV-1, MCV-2,MCV-3 i MCV-4. MCV-1 je najrasprostranjeniji, dok se MCV-2 najčešće vidi u odraslih. Način prijenosa i rizične skupine Budući da se radi o spolno prenosivoj bolesti, najčešći način prijenosa je nezaštićeni spolni odnos. Kako se virus širi sa osobe na osobu kontaktom s oštećenom kožom, može se prenijeti i preko ručnika, odjeće ili igračaka. Kod zaražene osobe, virus se vrlo lako širi dodirom ili grebanjem i na druge dijelove tijela. Najčešće zaražene skupine su: spolno aktivne osobe mlađe dobi, zatim djeca (1 do 10 godina) i imunosuprimirani, rijetko osobe starije životne dobi. Znakovi i simptomi Molluscum contagiosum Najčešće se očituje izraslinama (papulama) oblika kupole, boje mesa i veličine 1 do 5mm u promjeru. Smještene su u području trupa, ekstremiteta (ruku i nogu) i prepona. Lezije nisu bolne, no često mogu svrbiti. Grebanjem nastaju rane koje mogu krvariti ili se naknadno inficirati. Rijetko, u oko 10% slučajeva, oko lezije se može razviti ekcem. Infekcija je lokalizirana na najviši sloj epidermisa, stoga cijeli bez ožiljka, osim u slučajevima grebanja koji dovode do oštećenja dubljih slojeva i superponiranih bakterijskih infekcija. Središnja jezgra sadrži virus i jednom kad se uništi, lezije više nisu zarazne. Papule obično nestaju nakon 6 tjedana do 3 mjeseca, iako kod djece i imunosuprimiranih osoba mogu zaostati i duže. Dijagnoza Molluscum contagiosum Dijagnoza se najčešće postavlja na temelju kliničke slike, te se može potvrditi ekscizijskom biopsijom. Histološki, Molluscum contagiosum karakteriziraju tjelešca u epidermisu, iznad bazalnog sloja, koja se sastoje od velikih stanica sa eozinofilnom citoplazmom koja sadrži virus i malim perifernim jezgrama. Liječenje Molluscum contagiosum Lezije najčešće nestaju spontano bez ikakvih posljedica. Preporučaju se higijenske mjere da bi se spriječilo širenje bolesti na druge dijelove tijela, te izbjegavanje grebanja koje može dovesti do krvarenja i naknadnih infekcija sa ožiljkastim cijeljenjem. Papule u području genitalija eventualno se mogu liječiti različitim lokalnim pripravcima, laserom ili kirurškim postupcima da se spriječi njihovo daljnje širenje. Prognoza Molluscum contagiosum Većina promjena nestaje u roku od dvije godine (najčešće do 9 mjeseci). Sve dok su prisutne kožne izrasline, mogući je prijenos infekcije na druge dijelove tijela, ali i druge osobe. Sa nestankom lezija, nestaje i mogućnost širenja zaraze. Za razliku od herpes virusa, koji ostaju u inaktivnom stanju i nakon nestanka promjena kože ili sluznice, Molluscum contagiosum virus nestaje u potpunosti zajedno sa papulama, osim u slučaju da se osoba ponovno inficira. Postoje dokazi da je Molluscum contagiosum u porastu od 1966. godine, ali se rutinski ne prati, jer je infekcija rijetko ozbiljna i najčešće nestaje spontano bez liječenja.