TOACS FCPS Station · Molluscum Contagiosum

📷 Clinical Photograph – Molluscum Contagiosum

Clinical photograph showing molluscum contagiosum lesions on the face and neck

Figure 1 · Molluscum Contagiosum · Poxvirus infection

🔍 Key clinical features:

✓ Flesh‑colored, dome‑shaped papules – 2–5 mm in diameter
✓ Central umbilication – characteristic dimple or depression
✓ Often asymptomatic – may become inflamed or eczematous before resolution
✓ Predominant sites – face, neck, axillae, and antecubital fossae
✓ Common in children – especially those with atopic dermatitis or immunocompromise

📋 Clinical scenario (examiner prompt)

A 5‑year‑old child with a history of atopic dermatitis is brought to the clinic with multiple flesh‑colored, dome‑shaped papules on the face, neck, and antecubital fossae. The lesions are 2–4 mm in diameter and have a central depression (umbilication). They are asymptomatic but some have become erythematous and slightly crusted. The child attends swimming classes and has a history of sharing towels with siblings.

Umbilicated papules Molluscum contagiosum Atopic dermatitis Poxvirus

🧑‍⚕️ Examiner tasks · TOACS

1. Identify the diagnosis from the clinical image and context.

2. Describe the clinical features (umbilicated papules, distribution, associated atopy).

3. Explain the etiology and transmission (poxvirus, direct contact, fomites).

4. Discuss management and prognosis (self‑limiting, symptomatic treatment, avoid in immunocompromised).

⚠️ Key concept: Molluscum contagiosum is a common, benign viral infection caused by a poxvirus. It is characterized by flesh‑colored, dome‑shaped papules with central umbilication. It is self‑limiting in immunocompetent children, but may persist or become widespread in patients with T‑cell dysfunction (e.g., atopic dermatitis, HIV). Treatment is usually not required; cryotherapy or curettage may be used for cosmetic reasons.

🎯 Expected answers (for examiners)

• Diagnosis: Molluscum contagiosum
• Clinical features: Umbilicated papules, face/neck/axillae distribution, often in atopic children
• Etiology: Poxvirus (Molluscum contagiosum virus); transmission via direct contact, fomites (swimming pools, shared towels)
• Prognosis: Self‑limiting in immunocompetent (resolve in ~2 months); may be persistent in immunocompromised
• Management: Reassurance, symptomatic care; cryotherapy, curettage, or topical agents for cosmetic or persistent lesions

⚡ Quick FCPS‑style MCQ

A 5-year-old with atopic dermatitis presents with flesh‑colored, dome‑shaped papules with central umbilication on the face and neck. The most likely diagnosis is:

A. Viral warts (HPV) B. Molluscum contagiosum C. Herpes simplex D. Varicella zoster

📌 Topic summary · Molluscum Contagiosum (Nelson)

Etiology
Poxvirus (Molluscum contagiosum virus)

Incubation
Up to 6 months

Clinical features
Umbilicated papules; face, neck, axillae

Associated conditions
Atopic dermatitis, HIV, immunodeficiency

Prognosis
Self‑limiting (2–3 months) in immunocompetent

Treatment
Usually supportive; cryotherapy/curettage for cosmesis

Feature	Molluscum Contagiosum
Virus family	Poxviridae
Transmission	Direct contact, fomites (swimming pools, shared towels)
Lesion morphology	Dome‑shaped, flesh‑colored, central umbilication
Common sites	Face, neck, axillae, antecubital fossae
Spontaneous resolution	Yes, in immunocompetent children (≈2 months)
Treatment indications	Cosmetic, persistent, or immunocompromised patients

🦠 TOACS FCPS Station · Molluscum Contagiosum

📷 Clinical Photograph – Molluscum Contagiosum

🧑‍⚕️ Examiner tasks · TOACS

📌 Topic summary · Molluscum Contagiosum (Nelson)