Case No. 125

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Case No. 125


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Chief Complaint:

Itchy bumps all over my daughter's body...

Published: Oct. 3, 2017
Author: venuscv

JA is a 4-year-old female who presents to your family medicine clinic with a 3-week history of "spreading bumps" on her underarms, trunk, and elbows. While the appearance of the bumps concerns JA and her parent, the most bothersome symptom of these bumps is the itch. According to her mother, JA is itching day and night. When you ask about exposures, the mother denies other siblings being affected by the bumps and no present or past history of bed bugs in their home. She states that besides attending school, JA participates in after-school swimming lessons at the local pool. Besides this recent presentation, JA is otherwise healthy with no significant medical history and her immunizations are up to date. When you go to perform a full skin examination on JA, you notice multiple firm dome-shaped, skin-coloured papules with central umbilication on her axilla, scapula, abdomen, and elbows, sparing the eyes and genital area.


What is your next best move?

  • Take a punch biopsy of the suspicious lesion.
  • Use liquid nitrogen to perform cryotherapy.
  • Reassure parents that the lesions are self-limiting and may clear on their own within 6-12 months.
  • Offer curettage and cantharidin as treatment options.
  • Offer podophyllotoxin as a treatment option.
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