Recognizing and Managing Eczematous Id Reactions to Molluscum Contagiosum Virus in Children

Abstract

Molluscum contagiosum (MC) is a self-limiting cutaneous viral eruption that is very common in children. MC infection can trigger an eczematous reaction around molluscum papules known as a hypersensitivity or an id reaction. In addition, a hypersensitivity reaction can occasionally occur at sites distant from the primary molluscum papules. These eczematous reactions are often asymptomatic or minimally pruritic. We believe that id reactions represent an immunologically mediated host response to MC virus and a harbinger of regression. Therefore, these reactions often do not require treatment other than emollients. Moreover, topical steroids or immunomodulators may suppress this process and potentiate the spread of the primary MC infection. However, in symptomatic patients, treatment should not be withheld and short-course treatments of topical corticosteroids may be used. In this case series, we describe 3 cases of hypersensitivity reactions in otherwise healthy children with MC. We hope that our report will make clinicians more aware of this common eczematous response to MC and will improve the management and counseling of these patients and their parents.

Molluscum Contagiosum in a Pediatric American Indian Population: Incidence and Risk Factors

“…Moreover, this age distribution has been noted previously in children <5 years old [13], [22]–[24]. Some authors have hypothesized that children in this age range have behaviors and activities that facilitate close contact with affected individuals, thereby facilitating the spread of MCV to others [23], [25], and others have suggested that maternal antibodies may protect newborn infants from infection [23]. Cases from the two IHS facilities examined in the present study had a slight predominance of female patients versus male.…”

Diagnosis of Atopic Dermatitis: Mimics, Overlaps, and Complications

“…For some patients, diffuse or discoid dermatitis develops surrounding some of these MC papules (molluscum dermatitis; MD) often masking the papules altogether (Figure 12). Patients (with or without AD) that develop MD have a prolonged and/or more severe course [43,44] possibly due scratching and autoinoculation to other skins sites; however, in some patients the apparent “spread” of MC lesions may be due to autoeczematization [45]. Secondary infection is uncommon and characterized by acute onset of tenderness and drainage.…”

Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement

“…52 There is, however, little evidence that treatment with TCS worsens any outcomes associated with infection. Conversely, children's eczema will often flare following primary skin infection.…”

“…Conversely, children's eczema will often flare following primary skin infection. 52 There is, however, little evidence that treatment with TCS worsens any outcomes associated with infection. Indeed, adequate treatment of the eczematous skin with TCS generally restores the barrier function of the skin and greatly aids control of any associated infection, without the need for antibiotic or antiviral treatment.…”