Clinical Review

Common skin infections in children

BMJ 2004; 329 doi: http://dx.doi.org/10.1136/bmj.329.7457.95 (Published 08 July 2004) Cite this as: BMJ 2004;329:95
  1. Michael J Sladden (m.sladden@doctors.org.uk), specialist registrar1,
  2. Graham A Johnston, consultant1
  1. 1 Department of Dermatology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW
  1. Correspondence to: M J Sladden
  • Accepted 23 May 2004

Introduction

Most children will have a skin infection at some time. Skin infections are a common reason for consultation in primary care and in dermatology practice.13 We review four common skin infections in children and describe their epidemiology, clinical features, and treatment, focusing on treatments with best evidence.

Sources and selection criteria

We searched Medline and the Cochrane Library using the terms “molluscum,” “warts,” “impetigo,” and “tinea.” We included randomised trials, meta-analyses, and clinical guidelines.

Molluscum contagiosum

Molluscum contagiosum is a common, benign, self limiting viral infection of the skin. It generally affects children and is caused by a human specific poxvirus. Infection is rare in children under 1 year of age and typically occurs in the 2-5 year age group.4 Although the prevalence of molluscum contagiosum is not known, one of six Dutch children have visited their doctor for the condition.5

Infection follows autoinoculation or contact with affected people.6 The incubation period is from two weeks to six months. The condition is more common in young children and in children who swim, who bathe together, and who are immunosuppressed. Little evidence supports the view that lesions (mollusca) are more common in children with atopic dermatitis.

Mollusca present as multiple dome shaped pearly or flesh coloured papules with a central depression (umbilication), which usually appear on the trunk and flexural areas (fig 1). They vary in size from 1 mm to 10 mm, with growth occurring over several weeks.4 In patients who are immunocompetent, lesions may persist for six to eight weeks. The mean duration is at least eight months when new lesions appear due to continuous autoinoculation.6 Resolution is often preceded by inflammation. Uncomplicated lesions heal without scarring.

Fig 1

Typical multiple dome shaped pearly or flesh coloured papules of mollluscum contagiosum, with a central depression (umbilication)

Credit: DOIA

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