This post is by regular contributor Naomi Cook.
I have just come from the playground where I witnessed a little girl clambering over the equipment with a naked underarm revealing a cluster of Molluscum Contagiosum (MC)… Mollusc what??? What is that??? Here is a little information on a skin rash commonly affecting kids.
What is it?
MC is a skin infection caused by the poxvirus. It is common in children and young adults and tends to affect boys more than girls.2 It is thought that the incidence is increasing.1 The incubation period (time from exposure to when symptoms develop) is generally 2-7 weeks2 but it can take up to 6 months.1
What does it look like?
MC is commonly referred to as a ‘rash’ however it is characterised by bumps/spots that are pearly white but with time can develop a tiny dimple in the centre. The spots contain a white cheesy like substance that discharges quite easily.2 They can be 2-5mm in size1 but can be as large as 3cm.2
What body part is affected?
Spots may appear anywhere on the skin, such as the face, neck, abdomen, arms, underarms, legs and genital area. The rash below occurs on the trunk of a two year old girl.
Note that on the lower part of her stomach it looks like another lesion is forming.
Spots can appear alone but tend to appear in clusters as each spot is capable of infecting surrounding areas of skin. In immunocompromised individuals the spots can become widespread.2 Adults may get MC in their genital areas which can be spread through sexual contact. It is possible that children may develop anal/genital lesions through touching this region with infected hands. It is worth saying that it is routine to check children for sexual abuse if a skin infection of the genitals occur,2 however the presence of MC in the genital region of a child does not necessarily mean abuse has occurred.
How does it spread?
MC is spread through direct contact with an infected person, through sharing toys, linen, towels, clothes and washcloths, gym/play equipment and benches.2 The virus does not enter into the blood stream and therefore is a local, not a systemic infection. Since the spots are capable of infecting local areas of surrounding skin, the infection can become self perpetuating. In addition an individual can spread the infection to multiple body parts with their own hands.
How can I treat it?
Although unsightly, the spots do not tend to cause any discomfort (although some may itch a little), therefore treatment can be minimal. Individual spots will generally last 2-3 months, can last 6-12 months. A group of spots can take up to 18 months to completely resolve.3 Some spots can remain for up to four years in those with a weakened immunity.1
Lesions may be removed for the purpose of preventing further spread both in the infected person and also to others. Lesions can be removed through treatment such as cryotherpy or through surgical removal. Removal of lesions is associated with an increased risk of scarring. 3 There are also a few creams that a doctor may prescribe.2 The infection will be gone once the spots have disappeared, the virus will not lay ‘dormant’ in the body like, for example, the herpes virus.1
Complications
Bacterial infection can occur especially if the child is scratching the area. Seek medical attention if this occurs as a local antibiotic ointment may be necessary.
How can I prevent the infection spreading to other body parts and to other people?
Children with MC should have the infected area covered up whilst in contact with other children. Clothes may provide a barrier but be careful when removing them not to touch non-infected areas of skin with the part of clothing that was in contact with the spots.
Dressings can be applied and water proof dressings are necessary if swimming. In addition children with MC should have their own kickboards and obviously not share towels with other children (or adults).1 After swimming the kickboards should be disinfected and dressings discarded at home.1 Dressings can be removed at night when there is little chance of transmitting the infection to others.
The CDC states that children who attend daycare should wear waterproof dressings on infected areas that are not covered by clothing.1 They also state that if MC is present in the genital area in these children then the spots should also be covered to prevent contamination of toilet seating. 1
The Royal Hospital for Children in Melbourne recommends that children with MC have showers as opposed to baths to avoid viral spread in bath water.4
DISCLAIMER: The information contained in this article should NEVER be used as a substitute for the advice of a licensed physician. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please see a physician if you think you or your child are unwell.
{Images: thanks to Shannon}
References
- CDC: What is Molluscum Contagiosum?
- eMedicineHealth: Molluscum Contagiosum
- PubMed Health: Molluscum Contagiosum
- Royal Children’s Hospital Melbourne: Molluscum
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