Molluscum update

[NotNow]

I made a comment a week or so ago about my having contracted Molluscum contagiosum. I mentioned that the dermatologist who made the diagnosis prescribed me a medication called Aldara (you'll sometimes hear of it under the name Imiquimod). The doc here said he had never heard reports of treating MC with that medication. Among the lots of research I have done about MC on the internet, I have learned it is only beginning to be studied as a treatment.



I have been using the medication since 2 weeks and it works well for the lesions on my lower abdomen. The lesions have become flat and have started to flake, get paler and lose strenght. In addition to this treatment, I have been through cryotherapy which helped neutralize the lesions that were already there (I had many). But the disease started to crawl to my scrotum area and, frighteningly, the lesions down there don't look at all like molluscum anymore like they did on my pubes or my lower abdomen. First of all, they itch and burn. There are 2 big lesions which look like ulcers with yellowish liquid coming out. Now, I am very paranoid about the fact that the dermatologist may have made the wrong diagnosis or that I may have, in addition to MC, contracted Herpes. I have looked at pictures of Herpes, and it kinda looks like what I have on my scrotum. Even the doctor who burned my lesions with liquid nitrogen asked me if the lesions looked whitish when they popped at first, meaning he wasn't so sure it was still MC.



Should I be paranoid? What should I be looking for to make sure I don't have Herpes in addition to MC?

[H. Hunter Handsfield, M.D.]

You should return to the provider treating your MC for advice.  Herpes doesn't commonly involve the scrotum.  However, if some imiquimod (Aldara is the brand name) got onto your scrotum--e.g., you spilled a drop or two and it didn't get washed off, you might get a burn-like or ulcerative lesions of the more sensitive scrotal skin.  But if your doct thinks the lesions were likely herpes, you should be tested for herpes simplex virus (HSV) by culture of the ulcers, if they are still fresh, and/or by blood testing for HSV-2 antibody.



To date the research in imiquimod for MC is almost entirely limited to children.  The need for alternative therapies is greater in toddlers and kids than adults, because they often have more lesions and more widespread ones, and the kids (and their parents) don't tolerate the quicker but more painful approaches like currettage (scraping the lesions off) or freezing.  The result in kids are promising.  But I don't see the advantage for adults, and I wonder why it is being used in your case.  Indeed, I doubt we will see much research in adults, with the possible exception of studies in HIV-infected persons with persistent or recurrent MC; the demand likely isn't sufficient to justify the manufacturer's investment in studying MC in healthy adults.



Good luck--  HHH, MD

[mtbb]

I used aldara to treat a possible wart on the shaft, and after about a week and a half i got pretty much what you are desribing on my scrotum also ... the skin got really nasty looking and started peeling etc ... my doc gave something he referred to as prescription strength hydrocortizone when it happened to me and it cleared up completely in 3 days with that and backing off of aldara

[NotNow]

Thanks doc and mtbb for your uselful replies. I will get a Herpes blood test just for peace of mind. I put hydrocortizone on it last night and this morning and the itching and burning are now completely gone. So I guess one disease will be enough for me.



As for why it is being used, well, my guess is that I have a disease and Aldara helps me get rid of it, it's as simple as that. It just seems to accelerate threefold the healing of the lesions. MC is really hurting me right now and anything I can do to heal it faster, I will use it.

[NotNow]

Allright, I just learned somewhere else NOT to put cortizone on viruses. So, obviously, I stopped doing it.