Ask A Specialist: When Should Patients With Molluscum Contagiosum Be Referred to Dermatology?Ask A Specialist: When Should Patients With Molluscum Contagiosum Be Referred to Dermatology? https://pediatricsnationwide.org/wp-content/uploads/2020/12/AdobeStock_32667489_mr-executive-functions-header-1024x575.gif 1024 575 Patricia Witman, MD Patricia Witman, MD https://secure.gravatar.com/avatar/e8cc06145f036e4c187654af97f8225a?s=96&d=mm&r=g
- September 27, 2021
- Patricia Witman, MD
What are the current treatment recommendations for moderate to severe molluscum, and when would you suggest referring to a dermatologist?
Molluscum contagiosum is an infection caused by a virus that typically results in benign, mild skin disease characterized by lesions (Mollusca) that are small, raised and usually white, pink or flesh colored with a dimple in the center.
In many cases, pediatricians suggest either a “wait it out” approach or a referral to a dermatologist, depending on the severity of the case and the family’s preference.
Molluscum contagiosum will eventually resolve without treatment, although this can take several months to a few years. Given that molluscum is a benign skin condition and that it will likely spontaneously resolve, reassurance to the parents and a watchful-waiting approach is reasonable.
As some lesions resolve, others may appear. It is also common for molluscum to become irritated with redness, pruritus and swelling. This represents a natural immune reaction against the virus that is seen before spontaneous involution.
Treatment can help prevent the spread of the virus to other body parts or people. Treatment of molluscum contagiosum is similar to that of warts.
Most lesions of molluscum contagiosum can be treated by the primary care physician. However, some circumstances may warrant referral to a dermatologist. These include:
- When the diagnosis is questionable
- When multiple treatments do not resolve the molluscum or when the condition has lasted for longer than one year
- When the molluscum contagiosum covers a large area of the body
- When lesions become infected, severely irritated or do not heal
- When the patient has immunodeficiency
To learn more about diagnosing and referring Molluscum contagiosum, and more information on when to refer to a dermatologist, download the practice tool for providers below.
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