Managing Molluscum Contagiosum: A 43-Year-Old Male with Axillary Rash
By: Dr. Ashley Baldree
At Village Dermatology, we regularly evaluate and treat patients with viral skin conditions that can resemble other common rashes. One frequently misdiagnosed condition is molluscum contagiosum, a viral infection characterized by small, pink, dome-shaped bumps that may become irritated. This case highlights the successful management of molluscum contagiosum in a 43-year-old male from the Katy and Houston, Texas area.
Patient Overview
A 43-year-old established male patient presented to our clinic with a moderate bumpy rash located in the left axilla (underarm region). The rash had been present for approximately two weeks, was not itchy, and the patient had not started any treatment before this visit.
Upon examination, additional lesions were noted on the left rib cage, axillary vault, posterior axilla, and lateral inferior chest, consistent with molluscum contagiosum.
Diagnosis: Molluscum Contagiosum
Molluscum contagiosum is a contagious viral skin infection caused by a poxvirus, commonly seen in both children and adults. It spreads via skin-to-skin contact or contaminated surfaces, including towels and shared water sources like swimming pools.
Characteristics Noted:
Umbilicated (central indentation) pink papules
Moderate inflammation
Distribution across the left chest and axillary region
Some lesions were irritated and itchy
Treatment Plan
At the patient’s previous visit, cryotherapy with liquid nitrogen (LN2) had been initiated. During this follow-up appointment, the patient reported significant improvement in his condition.
On this visit:
57 molluscum lesions were treated with 2 freeze-thaw cycles using a cotton-tipped applicator
Cryotherapy was used due to signs of inflammation and irritation
The procedure was medically necessary and consent was obtained
Counseling included:
Skin care tips to avoid spreading: avoid sharing towels, tight clothing, or scratching lesions
Treatment options discussed: cryotherapy, cantharidin, tape stripping
Follow-up scheduled in 1 month to monitor progress and provide additional treatment if needed
Why Cryotherapy Works for Molluscum
Cryotherapy involves freezing the lesion with liquid nitrogen, which helps destroy the infected tissue and stimulate the immune response. Most patients require multiple treatments, especially when the infection is widespread. For this patient, progress was already noted after just one session.
Preventing the Spread of Molluscum
Molluscum contagiosum is contagious but manageable. To minimize transmission:
Avoid scratching or picking lesions
Do not share towels, razors, or clothing
Practice good hygiene, especially after workouts or swimming
Use barriers (like clothing or bandages) over affected areas if needed
Conclusion
This case underscores the importance of early recognition and proper management of molluscum contagiosum in adults. At Village Dermatology in Katy and Houston, Texas, our providers are experienced in differentiating molluscum from other skin rashes and offering safe, effective in-office treatments like cryotherapy.
If you or someone you know has unexplained bumps or a persistent rash, don’t wait—schedule a skin evaluation today with our expert dermatology team.
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