Molluscum contagiosum (MC) is a common, benign viral skin infection characterized by distinct raised bumps on the skin. It is caused by a type of poxvirus.
Molluscum Contagiosum: A Brief Overview
Molluscum contagiosum is caused by the Molluscum Contagiosum Virus (MCV). The infection results in small, firm, dome-shaped papules, which have a pearly appearance and a central indentation or dimple. These lesions measure 2 to 5 millimeters in diameter and can be white, flesh-colored, or pink to purple. Common areas include the face, neck, arms, legs, trunk, and genital region. While usually painless, they may be itchy or inflamed.
Oral Molluscum Contagiosum: Occurrence and Appearance
While most commonly found on the skin, Molluscum contagiosum can rarely occur within the oral cavity. The mucosal tissue lining the mouth differs from external skin, contributing to the infrequency of oral lesions compared to cutaneous ones. When present, oral lesions resemble their skin counterparts, appearing as small, pearly, flesh-colored, or whitish papules. They retain the characteristic central umbilication, a small pit or depression.
These oral lesions can appear on various surfaces inside the mouth, including the buccal mucosa (inner lining of the cheeks), palate (roof of the mouth), gingiva (gums), tongue, and lips. Oral molluscum contagiosum is more frequently observed in individuals with compromised immune systems, such as those with HIV/AIDS, where lesions may be larger or more widespread. However, oral manifestations can also occur in individuals with healthy immune systems.
How Oral Molluscum Contagiosum Spreads
Molluscum contagiosum spreads through direct skin-to-skin contact with existing lesions. For oral lesions, transmission can occur if a person touches an existing molluscum bump on their body and then touches their mouth, a process known as self-inoculation. Direct contact with molluscum lesions from another person can lead to oral infection.
Sexual contact, particularly oral sex, is a route for the transmission of molluscum contagiosum to the oral cavity in adults. The virus can also spread, less commonly, through shared personal items like towels or clothing contaminated with the virus. The virus is not airborne, and its spread requires direct physical contact or contact with contaminated surfaces.
Steps for Diagnosis and Treatment
Diagnosis of molluscum contagiosum, including oral manifestations, is made by a healthcare professional based on the distinctive appearance of the lesions during a clinical examination. If the diagnosis is uncertain or lesions appear atypical, a biopsy may be performed for microscopic confirmation. Consult a doctor or dentist for an accurate diagnosis, as oral lesions can be mistaken for other conditions.
Molluscum contagiosum resolves spontaneously without intervention, clearing within 6 to 12 months, though some cases may persist for up to four years. Treatment may be recommended for persistent lesions, those causing discomfort, or to prevent further spread.
Common treatment options include physical removal methods such as cryotherapy (freezing with liquid nitrogen) or curettage (scraping off). Laser therapy can be used, particularly for numerous or difficult-to-treat lesions. Topical medications, including retinoids, imiquimod, cantharidin, salicylic acid, and potassium hydroxide, may be prescribed.
For oral lesions, treatment must be managed by a qualified healthcare provider due to the sensitive nature of the oral mucosa. Individuals with weakened immune systems may experience more extensive or persistent infections that may be more resistant to standard treatments.