Paeds Vivas · paediatric-dermatology
Molluscum contagiosum and viral warts — viva
Branching clinical structured oral on the diagnosis, pathophysiology and expectant-versus-active management of a child with molluscum contagiosum and a viral wart, including red flags for immunodeficiency.
On this page
Study tools
Target exams
RACP DCEMRCPCH Clinical
Prompt
A 4-year-old boy is brought to clinic with a cluster of small, shiny, pearly papules in the right axilla that have spread over six months, and a rough grey-brown papule on the thumb. He has atopic dermatitis and swims weekly. His mother wants both lesions frozen off today because she is worried about scarring and spread to his siblings. You are asked to assess and manage him.
Opening (2 minutes)
The candidate should recognise the two distinct diagnoses in this atopic child and commit to a conservative-first plan while addressing the mother's anxiety. The axillary lesions are molluscum contagiosum (a poxvirus producing pearly umbilicated papules) and the thumb lesion is a common viral wart (human papillomavirus producing a rough hyperkeratotic papule). Both are benign, self-limiting and transmissible, and the atopic dermatitis and swimming are relevant risk factors. [2]
References4ShowHide
- [2]Schaffer JV, Berger EM Molluscum Contagiosum JAMA Dermatol, 2016.PMID 27627044
- [3]Olsen JR, Gallacher J, Finlay AY, et al Time to resolution and effect on quality of life of molluscum contagiosum in children in the UK: a prospective community cohort study Lancet Infect Dis, 2015.PMID 25541478
- [8]Kwok CS, Gibbs S, Bennett C, et al Topical treatments for cutaneous warts Cochrane Database Syst Rev, 2012.PMID 22972052
- [7]Chao YC, Ko MJ, Tsai WC, et al Comparative efficacy of treatments for molluscum contagiosum: A systematic review and network meta-analysis J Dtsch Dermatol Ges, 2023.PMID 37199262