I read with interest the Dermclinic case on molluscum contagiosum in your February issue. I was a bit surprised by the last sentence, in which Dr Barber comments, "I often instruct affected young adults to pierce the top of the lesions and try to extrude the central core using lateral pressure with the rounded end of a popsicle stick or similar device . . ."
If autoinoculation is a common reason for spread of molluscum, why would the author instruct patients to extrude the lesion's central core? Wouldn't that encourage further autoinoculation via contaminated hands and skin?
---- Brian Gumbs, MD Bay Area Hospital Coos Bay, Ore
The exact mechanism of autoinoculation is unknown. The removal of the core is curative and--if performed carefully with attention to hygiene--should pose little threat of contamination.
---- Kirk Barber, MD, FRCPC Consultant Dermatologist Alberta Children's Hospital Clinical Associate Professor of Medicine and Community Health Sciences University of Calgary Alberta