Strange, rash-like bumps irritate children's skin - and mystify parent
Tuesday, November 16, 2004 7:48 AM PST
By Dr. Sue Abell
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E-mail this articleDear Dr. Sue,
Both of my children have a rash that has been present for about five or six months, and which I've been told is "warts." I've been told there's nothing we can do to treat it. My mother looked at their bumps and said it sure didn't look like warts to her. These are smooth, clear bumps and some of them have a white center that she thought might be pus. I'm concerned, and both of them keep getting more and more bumps. Help!
Dear Parent,
What you describe sounds like molluscum contagiosum. This innocent, but annoying viral skin infection is similar in some ways to common warts, but is caused by a totally different virus.
Most children who develop these skin lesions have no symptoms at all. Some, however, can experience itching or tenderness. Children who have eczema will commonly break out in an eczema-like eruption that is scaly and red and itchy in the same area.
A child can have a few molluscum, or hundreds. Each single bump will go away by itself in about two months, though others often take its place. Eventually all of them will go away, although the infection can last for months or even years.
Treatment is often not advised when the number of bumps is low, but there are some things that can be used to treat molluscum, and there can be reasons to consider treating. For one thing, the infection is contagious, although it is a fairly low-grade contagiousness. Secondly, your child can be causing the bumps to spread by scratching at them and inoculating virus into nearby areas. If the skin is broken or inflamed (as it is when there is an outbreak of eczema in the area) it's even easier to introduce virus into the skin.
Treating, when it is considered, is sort of a double-edged sword, however. Treatment nearly always involves irritating the skin still more. The lesions are sometimes frozen with liquid nitrogen (just like "real" warts). Another treatment is Retin-A, which is a prescription medication that is also used for acne. Care should be taken to apply it only each individual bump, and not the skin in between, since it can be very irritating.
It is also possible to open each individual bump and remove the white hard core that you see; once this core is gone that particular lesion will dry up. This therapy has the advantage of avoiding ongoing irritation of the surrounding skin, but the disadvantage of leaving each one open to bacterial infection. (Besides that fact that your child is unlikely to let you try this method.)
For now, watching and waiting is not unreasonable.. If the number of bumps, or their location, exceeds your frustration threshold, talk to your pediatrician again about treatment.
Dr. Sue Abell is a pediatrician at Child and Adolescent Clinic in Longview and the mother of four children. She welcomes questions about raising kids and children's health issues. Contact her in care of The Daily News, P.O. Box 189, Longview, WA 98632, or by e-mail through zimmerman@tdn.com
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