# Warts and Molluscum Contagiosum

> Warts and molluscum contagiosum for NEET-PG Medicine, covering HPV wart types, poxvirus features, Henderson-Patterson bodies, treatment and HIV-linked disease.

- Canonical URL: https://prepelephant.com/topics/neet-pg/medicine/warts-and-molluscum-contagiosum
- Exam / course: NEET-PG · Subject: Medicine
- Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team
- First published: 2026-10-14
- Last updated: 2026-10-14
- Reference basis: Rook's Textbook of Dermatology; Fitzpatrick's Dermatology; Ananthanarayan and Paniker's Textbook of Microbiology
- How to cite: "Warts and Molluscum Contagiosum", PrepElephant, https://prepelephant.com/topics/neet-pg/medicine/warts-and-molluscum-contagiosum

## Direct answer

Warts and molluscum contagiosum are common benign skin infections, with warts caused by papillomaviruses and molluscum contagiosum caused by a poxvirus. Warts are rough, keratotic papules, while molluscum produces pearly, dome-shaped lesions with a central umbilication. Both spread by contact, and both can be treated destructively or topically, although molluscum often resolves without treatment in healthy children.

## What you must remember

- **Common wart:** verruca vulgaris, caused mainly by HPV types 2 and 4, is a rough keratotic papule.
- **Plantar wart:** caused by HPV type 1, it grows inwards under pressure and is painful on walking.
- **Flat wart:** caused by HPV types 3 and 10, typically on the face and dorsum of the hands in children.
- **Anogenital warts:** caused by HPV types 6 and 11, which are low risk for malignancy.
- **Molluscum virus:** a poxvirus whose lesions contain intracytoplasmic inclusions called Henderson-Patterson bodies.
- **Molluscum lesions:** pearly, dome-shaped papules with a central umbilication, spread by direct contact and shared objects.
- **Self-limiting course:** molluscum usually resolves over months to years in immunocompetent children.
- **Epidermodysplasia verruciformis:** a defect in cell-mediated immunity with widespread warts and a risk of squamous cell carcinoma.

## Comparing a wart with molluscum

A 7-year-old child has several pearly papules on the trunk, while her brother has a rough, painful lesion on the sole of his foot. The table sets out how the two conditions differ in cause, appearance and course.

| Feature | Common wart | Molluscum contagiosum |
|---|---|---|
| Causative virus | Papillomavirus (HPV 2, 4, 1 by site) | Molluscum contagiosum virus, a poxvirus |
| Lesion appearance | Rough, keratotic papule | Pearly, dome-shaped papule with umbilication |
| Diagnostic clue | Black dots on paring (plantar); skin lines interrupted | Henderson-Patterson bodies on curettage |
| Usual course | Months to years; may persist | Self-limiting in healthy children; longer in HIV |

Both conditions are common in children and spread through close contact and shared surfaces. The diagnosis is usually clinical, and the appearance of the lesion, rather than laboratory testing, guides treatment. Plantar lesions are often confused with corns, so careful paring is a useful bedside test. Molluscum papules can resemble other pearly papules in children, and the central umbilication is the key feature.

## Where the exam tries to catch you

Questions on this topic often test the virus family, the diagnostic clue and the self-limiting nature of molluscum.

- **Trap:** warts are caused by HPV types 16 and 18. — **Correct:** common and plantar warts are caused by HPV types 1, 2 and 4, whereas types 16 and 18 are linked to cervical and other mucosal cancers.
- **Trap:** molluscum is a papillomavirus infection. — **Correct:** it is a poxvirus infection, and its characteristic inclusions are Henderson-Patterson bodies.
- **Trap:** molluscum always needs treatment. — **Correct:** it is self-limiting in immunocompetent children, but treatment is considered for cosmetic reasons, spread or extensive disease in HIV.
- **Trap:** plantar warts are painless. — **Correct:** pressure drives them inwards and makes them tender on walking, which helps distinguish them from corns.

## Frequently asked questions

### What is the characteristic appearance of molluscum contagiosum?

Molluscum contagiosum produces pearly, dome-shaped papules with a central umbilication, usually on the trunk, limbs and flexures. The lesions are caused by a poxvirus, and curettage of a lesion shows intracytoplasmic inclusions called Henderson-Patterson bodies. The papules may itch or become inflamed, but they are usually painless.

### Which HPV types cause common warts?

Common warts (verruca vulgaris) are caused mainly by HPV types 2 and 4, while plantar warts are typically caused by HPV type 1. Flat warts are associated with HPV types 3 and 10. These types are considered low risk for malignancy.

### What is epidermodysplasia verruciformis?

Epidermodysplasia verruciformis is a rare defect in cell-mediated immunity that predisposes to persistent, widespread warts caused by HPV types such as 5 and 8. The lesions are often flat and can progress to squamous cell carcinoma in sun-exposed skin. It is managed with long-term surveillance and protection from sunlight.

### How are plantar warts treated?

Plantar warts are commonly treated with keratolytic agents such as salicylic acid, or with cryotherapy using liquid nitrogen. Persistent lesions may need other destructive methods. Paring the lesion reveals characteristic black dots, which help confirm the diagnosis.

### Why does molluscum contagiosum persist in HIV-positive patients?

Molluscum contagiosum tends to be widespread and persistent in HIV-positive patients, because clearance depends on intact cell-mediated immunity. Lesions can be numerous and extensive, and they may need active treatment. Immune restoration with antiretroviral therapy often leads to improvement.