A 10-year-old boy has clusters of raised spots with a central dimple under the armpit area; what is the diagnosis?

A 10-year-old boy has clusters of raised spots with a central dimple under the armpit area; what is the diagnosis?

• A. Varicella
• B. Measles
• C. Impetigo
• D. Molluscum contagiosum

Answer: (D)

Central umbilication on dome-shaped papules in a child is the hallmark feature of molluscum contagiosum. These flesh-colored bumps often occur in clusters and can appear in intertriginous areas like the armpit due to rubbing or autoinoculation. The central dimple is what sets them apart from other common pediatric rashes. Varicella would present as vesicles at various stages across the body, usually very pruritic. Measles shows a widespread maculopapular rash with fever and respiratory symptoms. Impetigo causes honey-colored crusts from bacterial infection, not umbilicated papules. So the presentation fits molluscum contagiosum, a benign, self-limiting infection caused by a poxvirus.

Central umbilication on dome-shaped papules in a child is the hallmark feature of molluscum contagiosum. These flesh-colored bumps often occur in clusters and can appear in intertriginous areas like the armpit due to rubbing or autoinoculation. The central dimple is what sets them apart from other common pediatric rashes. Varicella would present as vesicles at various stages across the body, usually very pruritic. Measles shows a widespread maculopapular rash with fever and respiratory symptoms. Impetigo causes honey-colored crusts from bacterial infection, not umbilicated papules. So the presentation fits molluscum contagiosum, a benign, self-limiting infection caused by a poxvirus.