June Week 4: Benign Bumps

Articles

• Peds in Review: Molluscum
• Topical Treatments for Warts: Cochrane Review
• Arch Pediatric Adolesc Medicine: Duct tape vs. Cryotherapy for treatment of warts

Cases/Questions

Case 1

A mother brings her 6 year old daughter in for a clinic visit because she has several warts which the mother feels are unsightly and she would like to have them removed.  

First of all, she comments “warts are so gross, how did my beautiful daughter contract these things?  Is it because she doesn’t wash herself well in the bathtub?  I’m always telling her to quit playing in the dirt, she gets so dirty, I’m sure she got warts because she is so dirty.  Is this like a hygiene issue or something??”

After politely redirecting the mother, you get to her main question: “how can we get rid of these things?”  What are her options for treatment?  Which options are most effective?  Have the most side effects?

The child has one on her face, which of course the mother wants removed most of all.  What would you advice for treating a benign wart on the face?

The mother mentions she heard from a neighbor that covering the wart(s) with duct tape would get rid of it, is that true?

After answering all of her questions, you gladly refer her to Dr. Silverman for a consult, as she is (not surprisingly) not satisfied with your advice.

Case 2

A child comes to your clinic complaining of several small flesh-colored bumps in a little group on the legs.  They do not bother the child, but the parent is concerned because she has noticed more of them lately.  They seem to have a little dent in the middle of each one.  What is it?  Should the mom be concerned about these?  What if they were in the genital area, is that more concerning? Will they continue to spread?  How can she get rid of them?  Is a referral to dermatology necessary?