Definition And Description

We confine the term molluscum to an affection characterized by the development of small tumors of peculiar aspect, scattered more or less freely over the surface. These little tumors, or more properly tubercles, vary from the size of a hemp-seed to that of a pea. They are sessile or pedunculated, and each is furnished with a small depression or umbilicus, from which, by pressure, a thickish white substance, like sebum, may be made to protrude. Their color is usually that of the normal skin, but may be a little redder, with sometimes a translucent aspect. The little tubercles are most frequently met with on the face, but are sometimes encountered on the neck, chest, back, limbs, and genitals. Their number varies from three or four to twenty or thirty, or possibly more. They do not appear simultaneously, but successively, coming out one after another for weeks and months, so that in advanced cases they may be encountered in various stages. Having attained a certain size they may so remain for an indefinite period, but after a time usually discharge their contents, dry up, and shrivel away. Sometimes inflammation and suppuration occur. The affection is met with at all ages and in both sexes, but the majority of cases have been observed in young females. It has been frequently encountered simultaneously in several members of a family, and has thus given rise to the idea that it may be contagious. This point, however, cannot be considered as definitely settled, although the weight of evidence appears to me to be in favor of the contagion theory. The eruption is unaccompanied with pain or other subjective symptoms, and does not appear in any way to influence the general health.

Diagnosis

The diagnosis is simple, as there is no other affection characterized by the same special lesion that this is - namely, small pedunculated tubercles, which on pressure yield a whitish substance, that on microscopical examination is found to contain certain translucent, roundish, or oval bodies, commonly known as "molluscum corpuscles."

Prognosis

The prognosis is good, as the disease is perfectly and speedily curable.

Etiotogy

The affection under notice has its early seat in the stratum Malpighii, and not in the sebaceous glands, as maintained by some,* but the nature of the process is an obscure one, and if the prevalent view concerning its contagious nature be abandoned, we are utterly at a loss to account for its origin and development.

Treatment

The treatment of molluscum is exceedingly simple. All that is necessary is to destroy the tubercles that are present at the time of the patient's visit, and subsequently a few more that were hardly large enough to be seen the first time. The destruction may bo accomplished by shaving off the tubercles at the level of the skin, squeezing out the remainder of their contents, and then applying a nitrate of silver point, or a red-hot needle to the little cavity that remains.

* F'or the detailed evidence on this point the reader is referred to 87, 344.

Bateman (57) states that the internal use of arsenic is of service. I have never tried it, as the external measures just spoken of are usually sufficient. Sometimes the tubercles are so closely grouped as to become almost confluent and to form a patch of some size. In these cases, instead of using the knife, their destruction may be effected by the use of alkaline caustics.