Skip to content

Patient Case: Molluscum Contagiosum

Discussion

A 9-year-old boy is brought to the dermatology clinic by his parents due to the appearance of multiple small, skin-colored bumps on his chest and arms over the past two months. The lesions are painless, dome-shaped, and have a central dimple (umbilication). His parents report that the child is otherwise healthy and does not complain of itching or discomfort. However, they are concerned because the bumps seem to be slowly increasing in number.

The child is active in sports and frequently goes swimming at the community pool. There is no history of fever, systemic illness, or recent travel. A physical examination reveals several 2–5 mm papules with central umbilication, scattered across the chest and proximal arms, without signs of inflammation or secondary infection.

Given the classic clinical presentation, a diagnosis of molluscum contagiosum is made. The parents are reassured that this viral skin infection is self-limiting and typically resolves within 6–12 months. The physician discusses hygiene measures and avoiding scratching to prevent further spread. Since the lesions are not causing significant distress, watchful waiting is recommended, though options for removal, such as cryotherapy or curettage, are discussed if needed.

Questions
  1. What is the most characteristic feature of molluscum contagiosum lesions?
    A) Large, fluid-filled blisters with crusting
    B) Dome-shaped, skin-colored papules with central umbilication
    C) Painful pustules surrounded by inflamed skin
    D) Red, scaly plaques with well-defined borders
  2. How is molluscum contagiosum most commonly transmitted in children?
    A) Airborne droplets from coughing or sneezing
    B) Direct skin-to-skin contact and contaminated surfaces
    C) Bloodborne transmission through insect bites
    D) Sharing utensils and eating contaminated food
  3. What is the recommended management for most cases of molluscum contagiosum in healthy children?
    A) Immediate surgical removal
    B) Long-term antiviral medication
    C) Watchful waiting with hygiene precautions
    D) High-dose antibiotic therapy
  4. Which of the following populations is at higher risk for extensive molluscum contagiosum?
    A) Healthy teenagers with acne
    B) Immunocompromised individuals, such as those with HIV
    C) Elderly individuals with dry skin
    D) Newborn infants with jaundice
Reveal answers

Answers

  1. Answer: B) Dome-shaped, skin-colored papules with central umbilication
    • Molluscum contagiosum lesions are typically small, painless, skin-colored papules with a central dimple (umbilication). Large blisters with crusting (A) suggest varicella (chickenpox), painful pustules (C) are more characteristic of bacterial infections, and red, scaly plaques (D) are seen in conditions like psoriasis or tinea corporis (ringworm).
  2. Answer: B) Direct skin-to-skin contact and contaminated surfaces
    • Molluscum contagiosum is caused by a poxvirus and spreads through direct contact with infected skin or contaminated objects, such as towels and swimming pool surfaces. It is not airborne (A), bloodborne (C), or spread through food (D).
  3. Answer: C) Watchful waiting with hygiene precautions
    • Most cases of molluscum contagiosum resolve on their own within 6–12 months in healthy individuals, so treatment is usually not necessary. Surgical removal (A) is rarely needed unless lesions cause distress, antiviral medication (B) is not effective, and antibiotics (D) are only required if secondary bacterial infection occurs.
  4. Answer: B) Immunocompromised individuals, such as those with HIV
    • People with weakened immune systems, particularly those with HIV/AIDS, may develop widespread or persistent molluscum contagiosum lesions. Healthy teenagers with acne (A) and elderly individuals with dry skin (C) are not at higher risk, and newborns with jaundice (D) do not have an increased susceptibility to this viral infection.

Are you a Medical Doctor?