Molluscum Contagiosum (Pediatric)

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Overview

Molluscum contagiosum is a common viral infection of the skin that resolves on its own, usually within a few months. It is caused by the poxvirus and affects only humans. It can spread to other areas of the skin by scratching or rubbing and can be transmitted to other people by skin-to-skin contact or handling contaminated objects such as towels, toys, and clothing. Poor hygiene and warm, moist climates encourage the spread of molluscum contagiosum. Use of public swimming pools is a common source of childhood infections.

Who's at risk?

Children aged 2–5 years are most commonly affected with molluscum contagiosum, although it can occur in adolescents and adults. It is rare in children aged younger than one year. Children with eczema may be more severely affected by molluscum contagiosum.

Signs and Symptoms

One or more small (1–10 mm) pink, skin-colored or pearly, dome-shaped bumps, often with a tiny dimple in the center, occur in clusters and sometimes in a straight line in molluscum contagiosum. The bumps are usually painless and may occasionally itch. Individual bumps may get bigger over the course of 6–12 weeks. Usually the bumps do not grow larger than 10 mm, but in patients with weak immune systems, they can be larger than a nickel.

Infections may be:

  • Mild – under 10 lesions
  • Moderate – about 10–50 lesions
  • Severe – over 50 lesions
Common areas for molluscum contagiosum lesions are the chest, abdomen, back, armpits, groin, or backs of the knees. Occasionally, they can be seen on the face and genital region. Because the incubation period for molluscum contagiosum is 2 weeks to 6 months, lesions may not immediately be seen after contracting the virus. Molluscum contagiosum infection is self-limited, and lesions will go away on their own in 6–9 months, although they rarely can persist for a few years. As the bumps begin to resolve, they may initially appear more inflamed, with pus and crusting of the lesions, before they eventually fade. They usually do not leave a scar.

Self-Care Guidelines

Treatment of mild molluscum contagiosum infections is often not required because lesions will eventually resolve on their own. However, you can decrease the chance of spreading the infection to other parts of your body or to other people with the following guidelines:

  • Do not scratch or shave the affected areas.
  • Avoid sharing clothing, towels, and bedding with others.
  • If the affected area is small, keep it covered.

When to Seek Medical Care

See your child's doctor if the molluscum contagiosum infection is moderate or severe or if you are concerned about spread of infection or its appearance.

Treatments Your Physician May Prescribe

Your doctor will most likely be able to diagnose molluscum contagiosum by its appearance. Very rarely, a biopsy is required.

Again, this viral infection will resolve on its own within a few months. Talk to your child's doctor about whether he or she recommends treatment or watchful waiting. No treatment is 100% effective, and most can have side effects such as pain or irritation of the skin.

Possible treatments include the following:

  • Cantharidin 0.7% or 0.9% liquid – This is an extract from the blister beetle. It is applied to the lesions and then washed off in 2–6 hours. It is not for use on the face or genitals.
  • Removal with freezing (cryosurgery), scraping (curettage), or burning (electrocautery) – All of these options may be painful.
  • Salicylic acid
  • Podofilox (Condylox®)
  • Tretinoin (Retin-A®)
  • Trichloroacetic acid
  • Silver nitrate paste
  • Imiquimod cream (Aldara®) – This may be useful for widespread, difficult-to-treat lesions.

Trusted Links

Clinical Information and Differential Diagnosis of Molluscum Contagiosum (Pediatric)

References

Bolognia, Jean L., ed. Dermatology, pp.1266. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.2114, 2116, 2332. New York: McGraw-Hill, 2003.

Sladden MJ, Johnston GA. Common skin infections in children. BMJ. 2004 Jul 10;329(7457):95-9.

Wynnis T, Friedlander SF. Poxvirus Infections.Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, eds. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, NY: McGraw-Hill; 2008:1899-1913.

van der Wouden JC, Menke J, Gajadin S, et al. Interventions for cutaneous molluscum contagiosum. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD004767.