by Dr. Barrett Labrum, DO, pediatrician, Primary Care Pediatrics
Kids get rashes. Sometimes these rashes are easy to identify, but sometimes they’re not. Sometimes they itch, sometimes they don’t. Sometimes they just show up, leaving us curious as to what’s going on. You may have noticed a few small bumps appear on your child’s arm. They look like warts, only a little different. They don’t usually itch but seem to spread. You may have taken your child to the doctor and received the news: Your child has molluscum contagiosum.
Molluscum contagiosum is a common skin condition that occurs in children. It’s so common that I often wonder why no one has ever heard of it. I call it the Great Secret of Pediatric Dermatology, plus it sounds like it’s from “Harry Potter.” Molluscum is a self-limited, benign skin condition that looks like growths on the skin. It’s often found in the axilla, arm creases, leg creases and below the underwear. Sometimes it can cause a redness and inflammatory response known as “molluscum dermatitis” that is itchy and bothersome to a child. It’s regularly found in “crops” of two to 20 lesions and looks like flesh-colored bumps known as “papules” that often have a small dot or hole in the center, which are frequently confused as small bug bites or small warts.
Molluscum is caused from a virus known as “molluscum virus” (I know, it’s very creative), a type of virus from the poxvirus family. The incubation period is usually two to six weeks, but can be as long as six months. The virus can spread from direct contact with the lesions, picking at them or using a fomite, such as a towel or contact sports. Although it can spread, it’s not recommended to remove patients from school or daycare. Take proper care to cover lesions when possible and avoid sharing towels or bathing sponges. Cover lesions when your child plays contact sports but don’t ban them from swimming pools.
How do you know if you have it? Most diagnoses can be made by a trained medical provider through visual inspection. Laboratory studies are not needed for this particular condition. Treatment options are limited and a little controversial. Most treatments are dependent on medical providers. Treatment options include doing nothing. The lesions will self-resolve between two and 12 months, but some cases show that the disease can persist up to five years. Other treatment options, with very limited data, include cryotherapy with liquid nitrogen, curettage (cutting off the lesions), cantharidin (a topical blistering agent) or podophyllotoxin (a topical agent). Treatments options should be discussed with your medical provider.