Discussion

The case image shows molluscum contagiosum (MC). The patient should be referred to a pediatrician for further evaluation and treatment.

MC is a condition characterized by multiple pink papules that are approximately 5 mm in diameter and may be clustered together. They are typically umbilicated with a central depression, but this only occurs in approximately 25% of lesions. The lesions may be pink, white, yellow, or clear. The most common location is the buttocks, but other areas may be affected. 

The cause of MC is a poxvirus, and the condition is thought to spread by direct contact. Children and immunosuppressed individuals are at increased risk for MC. Lesions are most commonly treated with freezing. Left untreated, lesions may eventually shrink and disappear, although they may persist for months.           

The patient’s viral cold resolved; his lesions were successfully treated with cryotherapy by his pediatrician.

Table. Molluscum Contagiosum

Description
  • Caused by a poxvirus
  • Lesions are flesh-colored/white/yellow/clear 3-5 mm
  • Umbilicated in 25% of cases
Risks
  • Pediatric patients
  • Sex
  • Immunosuppression
Treatment
  • Lesions resolve on their own in months to years
  • Curette
  • Tretinoin
  • Freezing
  • Potassium hydroxide
  • Cantharidin
  • Imiquimod

Reference

Pregerson DB. Emergency Medicine 1-Minute Consult Pocketbook. EMresource.org; 2017;5.