I kept my grandchildren this weekend, and I noticed a few warty bumps on my granddaughter's arms. Her mother said that it was something called "Molluscum", and that it would just go away. It sounds just awful to me. I think she should see a specialist. What do you think?
Molluscum contagiousum is a skin disease that is caused by a virus and it primarily affects humans. It is very common in pediatrics, affecting 5-8% of all children--most of which are under 10 years of age.
It is usually spread by direct contact with an infected individual, however it can occassionally be spread by fomites (inanimate objects). The incubation period is not known, but it is most likely in the range of 2-8 weeks.
The typical lesion of Molluscum is a discrete dome-shaped little bump measuring from 1-5 millimeters. It is usually translucent, pearly white, or skin colored.
There is usually a central dimple or "umbilication", which gives it its' characteristic appearance. If squeezed, a central core or plug of cheesy material can be expressed.
The lesions are self-limiting and benign. They do not cause any symptoms at all, and if left alone, they will ultimately go away. This can take months or even years, but it is in no way harmful or dangerous.
There are many different treatments available for Molluscum. These include freezing with liquid nitrogen, "coring" out the central plug with a sharp curette, applying benzoyl peroxide, a salicylic-lactic acid preparation, or retinoic acid (Retin A). Many physicians however just opt to treat with "tincture of time", as the lesions will go away on their own.
The decision whether or not to treat has to be made on an individual basis. If the patient has an incompetent immune system, or has severe eczema, the tendency would be to treat the Molluscum aggressively. If the lesions were in a highly cosmetic area, or the child was self-conscious about the lesions, a decision to treat would be prudent. If, on the other hand, the child had a few lesions on the trunk or extremities, and he/she were in good health, most physicians would be inclined to observe over time. It sounds as if this was the case with your granddaughter.
If there is any question about the diagnosis, or if things are not progressing as you think they should, have the doctor re-check your granddaughter. He may want to refer her to a skin specialist to confirm the diagnosis.