A common rash in young children and adolescents is called
molluscum contagiousum. The name
is unfortunate – they are minimally contagious. A sibling might catch them from another
sibling, but they don’t spread through the daycare.
They are little raised bumps that are white and have a mucous-like
substance in them. If you lift off the thin membrane covering the bump, a
white wad of mucous comes out. They can occur in a group or on different areas
on the body. They do not have any redness or irritation around them and they do
not hurt or itch (although if they are picked at or rubbed, they can get
inflamed or infected). If you look closely, you will see a small
“belly-button-like” dimple directly in the center of the bump. They are usually
all about the same size but sometimes can vary in size.
If your child has red, raised, itchy lesions, which are various sizes
and seem to come and go, he probably has hives. Molluscum contagiosum comes on
and stays – often for weeks.
No treatment is necessary for molluscum contagiosum. If left alone, they
finally go away just as mysteriously as they came. If they get infected,
covering them with an antibacterial ointment and a band-aid usually heals them.
However, any red, swollen, painful skin lesion needs to be seen by the child’s
caregiver.
There has always been a discrepancy between the way dermatologists and
pediatricians deal with molluscum contagiosum. Dermatologists treat molluscum
aggressively by picking each lesion off, burning them off or putting
wart-removing chemicals on them. I found early in my career that after I picked
off 25 or so molluscum, the child was bloody and crying, the mother and even
the nurse were crying and, within 2 weeks, a hole new crop of molluscum would
pop up. Dermatologists insist that by treating molluscum they go away faster,
but I’ve never found that to be the case. I’ve also never found the minimal
improvement that treatment affords to be worth the discomfort (and sometimes
scarring) caused by the treatment.
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