Characteristics of Molluscum Contagiosum

I just wanted some clarification on the appearance of molluscum. Does it always produce a cheesy white core? Or is that only in the mature stage of the infection before it's about to heal?

I've noticed a small, soft bump about 1 - 2 mm in size that is skin colored with an indentation in the center like it was poked with a pin. I've had it for about three months, but it has never produced the white core I've read about. It looks like molluscum when I compare it to pictures so I'm fairly confident that is what it is. I just wanted to know if it usually has an indentation in the center OR the white core or if it has an indentation in the center AND the white core in addition? Is it one or the other or is it both?

[Bhupinder Kaur, MD]

Hello,
Molluscum presents as multiple well-defined papules with a central umbilication. You can get the diagnosis confirmed after a physical examination from a dermatologist. White core may not be present in small lesions.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[chicagoguy89]

Thank you for your response, Dr. Kaur. I called to make an appointment to have it checked out, but the earliest they could get me in is three weeks from now. I spoke to a nurse and asked what some treatment options were if it was in fact molluscum. She said most likely they would either do freezing or evisceration but she didn't go into much detail. What is evisceration and would you recommend this? Should I just let it be and let it go away on its own?

[Bhupinder Kaur, MD]

Hello,
Evisceration of molluscum means scooping out the white core of the lesion. But evisceration cannot be performed on all Molluscum papules, particularly young papules. Moreover it leads to scabbing and potentially scarring (however unlikely), so aesthetic outcome may be effected. Also it is easy to spread the virus to surrounding tissue while eviscerating by handling the waxy core.
I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[chicagoguy89]

Hi doctor. I have read that the virus is contained within the white core. Does that mean that molluscum is only contagious when the white core is present?

Also, I've read differing accounts on the healing process. I've read that they grow in size, become red, and then begin to heal. I've also read that they just shrink and eventually disappear. Can you shed some light on this?