Complications
Pruritus and erythema commonly complicate molluscum infections.
Appropriate treatment for atopic dermatitis should be started.
Post-inflammatory skin changes (post-inflammatory hyperpigmentation, post-inflammatory hypopigmentation) are more likely in brown and black skin, and may take up to 12 months to resolve.
Occurs in 7% of patients; heals naturally and is rarely permanent.
May be caused by the body's immune response or by use of phenol, which increases the risk of pitted scarring and is not recommended.
Id reactions associated with molluscum appear as lichenoid papules on the extensor surfaces, which are pruritic and eccentric to the site of molluscum.
Treatment consists of removal of the inciting molluscum lesions, and management of symptoms of pruritus and local irritation that cause the patient discomfort.
Erythema multiforme-like dermatitis appears around the molluscum with annular hyperpigmented and violaceous plaques, which have an outer zone of redness and relative lightening in the centre surrounding the molluscum. This latter reaction is generally accompanied by an id reaction.
Bacterial superinfection may be caused by local entry of bacteria into the skin at the site of molluscum. Some therapies that denude the skin may enhance the risk of bacterial superinfection.
The treatment depends on the clinical disease appearance. Local impetigo and folliculitis can be treated with topical antibiotics.
Scratching of molluscum will compromise the skin barrier and increase the chance of bacterial infection, particularly in children with atopic dermatitis.
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