Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
After an incubation period of two to seven weeks, the molluscum contagiosum rash begins as tiny papules (small raised
bumps), each measuring 3-6 mm (about one-eighth to one-quarter inch). Some may be as large as 3 cm (1.2 inches) across.
The MC rash initially appears as smooth, pearly to
flesh-colored, dome-shaped papules. With time, the center becomes soft and
indented (umbilicated) with a white curdlike core. This core may be squeezed
out easily. There may be redness and scaling at the edges of a lesion from
inflammation or scratching.
Lesions may be located on any area of the skin or
mucous membranes (such as the mouth or conjunctiva, the membrane that covers
the eyes). They are usually grouped in one or two areas, but they may be
widely spread. Most commonly, they are found on the face, eyelids, neck,
underarms, and thighs. Adults often get them in the genital area. Usually,
fewer than 20 lesions appear, but several hundred are possible.
It is rare to find the rash in the mouth or involving
the palms or soles.
Usually, there is no itching or tenderness, and there are no generalized symptoms such as fever, nausea, or weakness.
People with impaired immune systems can develop multiple widespread, persistent, and disfiguring lesions, especially on the face and possibly involving the neck and trunk. These lesions can come together
(coalesce) to form giant lesions. Examples of people with weakened immune systems include those with cancer or AIDS or people
taking medications such as steroids that cause impairment of the body's
In some cases, development of severe MC may be an
indication of infection with the AIDS virus, HIV. Most people with MC, however, have no such serious underlying medical problem.