North Texas Research Forum 2025
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Division
North Texas
Hospital
Medical City Fort Worth
Specialty
Dermatology
Document Type
Poster
Publication Date
2025
Keywords
molluscum contagiosum, viruses, atopic dermatitis, molluscum dermatitis
Disciplines
Dermatology | Medicine and Health Sciences | Virus Diseases
Abstract
Atopic dermatitis (AD) is a chronic relapsing condition characterized by irritation, redness, inflammation, and itching of the skin. The cause of AD is theorized to be multifactorial, including genetic components, such as mutations in filaggrin, environmental exposures, and immune predisposition. AD often presents in childhood and adolescence, but can appear at any age. AD eruptions arise through various triggers, which commonly include soaps, detergents, fabrics, and cold or hot weather. Importantly, viral infections can also serve as a trigger, causing systemic inflammation via host defense mechanisms. Molluscum contagiosum (MC) is a double-stranded DNA virus that classically manifests as small, dome-shaped, skin-colored to pink, umbilicated papules. MC is very common, highly contagious, and often spreads via direct person to person contact. It can also spread from an affected to unaffected area of the body through autoinoculation. Molluscum dermatitis is the manifestation of an AD episode, triggered by MC. Patients with a history of atopic dermatitis are more likely to have eruptions associated with MC lesions. Interestingly, molluscum dermatitis is deemed the “beginning of the end” (BOTE), a positive finding indicative of host mechanisms working to resolve MC infection. We share this case as a presentation of AD flare secondary to molluscum contagiosum infection in a pediatric patient. Case Presentation: An 8 year-old boy with family history of atopic dermatitis presented with parents for red itchy rash and bumps. Patient’s mother reported that symptoms initially began with a rash on the back of the patient's neck, following a haircut in May 2024. Shortly afterwards, this rash began to spread across his body, with bumps becoming more numerous. He was intermittently treated with hydrocortisone 2.5% ointment (brother’s prescription) with mild symptomatic relief, but without improvement in rash. On examination, there were eczematous plaques on the anterior neck, supraclavicular region, upper chest, right arm, and axilla. Within these plaques were numerous small skin-colored umbilicated papules, some in a linear arrangement. Learning points: We share this case demonstrating molluscum dermatitis in a pediatric patient. The manifestation of AD in this patient was likely directly linked to recent infection with MC, due to systemic inflammation caused by viral load, thus subsequently causing the eruption. Molluscum dermatitis is often referred to as the “beginning of the end” (BOTE) sign and represents host responses preceding the resolution of MC infection. Molluscum dermatitis is commonly mistaken for a complication of MC, and all physicians should take this point into consideration when diagnosing patients.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Furth, Garrett; Mayer, Olivia; Hall, Marshall; Lim, Henry; Scheufele, Christian; Carletti, Michael; and Weis, Stephen, "Molluscum Dermatitis in a Pediatric Patient" (2025). North Texas Research Forum 2025. 25.
https://scholarlycommons.hcahealthcare.com/northtexas2025/25