Are These Asymptomatic Bumps Genital Warts?
These asymptomatic bumps developed on the groin area of a 16-year-old girl after her first sexual exposure.
(Answer and discussion on the next page.)
Answer: Molluscum contagiosum
This teenager had contracted molluscum contagiosum, B, a viral infection that can resemble warts. On close inspection, each lesion has a central umbilication, which distinguishes it from a wart.
HPV infection in women can cause genital warts, which should be considered in the differential. Bacterial folliculitis is typically tender and pustular. A milium appears as a deep whitehead–type comedone.
Molluscum contagiosum has 2 peaks of incidence1:
- The first is in children, in whom transmission occurs from nonsexual skin contact.
- The second is in young adults (aged 15 to 29 years), in whom the infection is usually sexually transmitted.
Topical treatments include the following:
- Cantharidin: A single application that may need to be repeated once or twice every 3 to 4 weeks.
- Tretinoin cream (0.1%) or gel (0.025%): Applied daily until the lesions resolve.
- Imiquimod cream 5%: Applied daily until the lesions resolve.
- Trichloroacetic acid: A single application that can be repeated at 3 to 4 weeks as needed.
- Cryotherapy with liquid nitrogen.
- Pannell RS, Fleming DM, Cross KW. The incidence of molluscum contagiosum, scabies and lichen planus. Epidemiol Infect. 2005;133:985-991.
1. Pannell RS, Fleming DM, Cross KW. The incidence of molluscum contagiosum, scabies and lichen planus. Epidemiol Infect. 2005;133:985-991.