The child presents with asymptomatic, flesh-colored papules that show central umbilication, which is characteristic of molluscum contagiosum. Molluscum contagiosum is a member of the poxvirus family that causes a localized infection consisting of nonerythematous, pearly, dome-shaped papules on the skin. However, this infection frequently leads to localized dermatitis, causing the surrounding skin to become pink, dry, and pruritic. As the papules resolve, the skin may become inflamed and crust over for a week or two.
Molluscum contagiosum is a common disease of childhood and often spreads via direct skin-to-skin contact or via indirect contact such as with the sharing of bath towels. An association with use of swimming pools has been reported and is likely where this patient became infected. The lesions may appear anywhere on the body except the palms and soles, and are usually self-limited in immunocompetent people. If the lesions appear on the genitalia of sexually active people, it is considered a sexually transmitted disease. In immunocompromised patients, particularly those with HIV-positive status, lesions can be quite large (eg, giant molluscum) and widespread.
Molluscum contagiosum is not caused by adenovirus, hepadnavirus, herpesvirus, papillomavirus, or polyomavirus. Adenovirus commonly presents with pharyngitis and coryza, and hepadnavirus causes hepatitis B. Herpesviruses are responsible for genital herpes and cold sores (HSV-1 and -2) as well as chickenpox and shingles (varicella zoster). Papillomavirus causes the common wart in children, and reactivation of the polyomavirus results in progressive multifocal leukoencephalopathy (PML) in immunosuppressed patients.