Advertisement

Advertisement

A Scaly Periorbital Rash in a Preschool-aged Boy

Jennifer Smitten, MD, FRCPC,1 Joseph M Lam, MD, FRCPC,2

1BC Children's Hospital, University of British Columbia, BC.
2Assistant Clinical Professor, Department of Paediatrics, Associate Member, Department of Dermatology, University of British Columbia, BC.

CLINICAL TOOLS

Abstract: A healthy 4-year-old boy presented with an 8-month history of a pruritic scaly eruption around his right eye associated with several small pearly papules on the face. A clinical diagnosis of an eczematous id reaction to molluscum contagiosum was made. While up to 40% of cases of molluscum contagiosum may have an associated eczematous dermatitis, these are often under-recognized or misdiagnosed.
Key Words: Pediatrics, Dermatology, Dermatitis, Molluscum, Eczema, Id reaction, Viral exanthem, Hypersensitivity.
Eczematous id reactions to molluscum contagiosum (MC) in children are common, occurring in up to 40% of cases of MC.
Id reactions to MC can be challenging to diagnose, as they may occur at sites distant from the MC lesions.
Id reactions can be caused by a variety of infectious and noninfectious dermatoses.
Asymptomatic id reactions do not require pharmacologic treatment and a watchful waiting approach is reasonable.
1. Id reactions can be caused by a variety of infectious and noninfectious dermatoses, including allergic contact dermatitis to nickel, scabies infestation, tinea infection and molluscum infection.
2. In a unilateral eczematous dermatitis, consider molluscum dermatitis, especially in a child with no personal or family history of atopy.
3. Treatment of symptomatic id reactions may help to reduce spread of MC via autoinoculation from scratching.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.