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Thread: The Clam in Thailand

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    The Clam in Thailand

    Molluscum Contagiosum

    Molluscum contagiosum (MC), often called “the clam” in Thailand, is a viral skin infection which produces small, firm, raised spots or eruptions on the skin forming in little clustered lesions. These are usually painless, but some reports mild to mederate itchiness. The infection is not serious and can clear up without any treatment, but the lesions can be annoying unattractive. This disease is confined to the skin and the mucous membranes. It is transmitted through direct skin contact with an infected person. The infection is actually a worldwide endemic, and has a higher incidence in children, sexually active adults and those who are immuno-deficient. It is prevalent in Thailand as a sexually transmitted disease. Another factor may be the tropical climate and the living conditions (overcrowding, poor hygiene, etc.).

    Causes

    “The Clam” is caused by the molluscum contagiosum virus and is transmitted through direct skin contact. Handling objects that has come in contact with the infection, also called formites, is also one of the reasons for transmission. There are four types of the virus, MCV-1 to -4. MCV-1 is the most prevalent while MCV-2 is seen usually in adults and often sexually transmitted. MCV-2 is the most common type found in Thailand. The average time of incubation and appearance of lesions is 2-7 weeks and can stretch up to 6 months.

    Signs and Symptoms


    MCV lesions appear to be smooth and dome-shapes and are generally skin-colored with opalescent character. They are not painful, but sometimes itchy and easily irritated. Scratching of the lesions can cause to eruption which may lead to infection and scarring. The center of the lesion that appears waxy and depressed contains the virus. The size of the lesion may vary depending on the stage of development, but usually averages 2-6 mm. The infection is limited to a localized area of the topmost layer of the skin, but sometimes it can develop on neighboring skin areas as well. This is called autoinoculation and children are more susceptible to this.
    The virus mostly affects the trunk of the body, arms, and legs. For sexually-transmitted MCV, it affects the groin, genital area, thighs and lower abdomen.

    Diagnosis

    The diagnosis for molluscum contagiosum is clinical appearance. The virus cannot be cultures in the laboratory although the diagnosis can be confirmed through excisional biopsy.

    Treatment

    Molluscum cantagiosum is a self-limited disease. The lesions can generally last from 2-3 months and may disappear on their own. Considering the high possibility of autoinoculation, it is best seek medical attention in order to control the spread of the virus. Treatment is often unnecessary but due to inoculation, it is highly considered by many. It should be noted though that treatments means to traumatize the lesions, which can leave pigmentary alterations or scarring.
    Some treatments for MCV available in Thailand include:

    Cryosurgery – Apply liquid nitrogen (dry ice) to each individual lesion. Repeat treatments in 2-3 weeks interval.

    Podophyllotoxin – Apply 15% (Indian podophyllum) or up to 25% solution (American podophyllum) on the warts once a week. Leave for 1-6 hr then wash off. Stop the treatment if no improvement is observed after 6 weeks. Alternatively, apply 0.5% alcoholic gel or 0.15% cream two times a day for 3 days but do not wash off. Repeat for up to 5 weeks.

    Salicylic Acid – After cleaning the area, apply 60% solution directly then cover with plaster. Repeat the process until lesions become soft which will be about 3-7 days.

    Imiquimod – As 5% cream, apply 3 times weekly for 4 weeks. The cream is applied at night and left on the skin for approximately 8 hours then wash off with mild soap and water. If no improvement is observed, a 4 week interval is needed before starting again on a 4 week treatment.



    For more information and Cure we recommend these books


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    The Complete Guide to Natural Remedies for STD STI



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    Last edited by Pee Baa Jub Jub; 27th April 2012 at 15:39.
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