Mixed diagnoses – 10 cases (6 of 11)

This is molluscum contagiosum, a common benign skin infection caused by a pox virus. Individual lesions are umbilicated skin-coloured papules 2 to 5 mm in diameter with a soft white core. The lesions favour the flexures and are frequently surrounded by eczema (dry red itchy skin), even in non-atopics. Immunosuppressed children and adults often develop particularly extensive infections.

Not all cases require active treatment as molluscum contagiosum resolves spontaneously. Infections have generally cleared within two years. Destructive measures may be used to remove individual lesions. Inexpert treatment may result in scarring; this is rare if lesions clear on their own. Treatments include: expression of the white core; salicylic acid applications (wart paint); cantharidine (extract of blister beetle) applied cautiously; cryotherapy; curettage or shave excision (if necessary using topical local anaesthetic).