Neftaly Austin Buch Pichol | Guatemala

Background

AGE: 9 years old
COMMUNITY: San Andrés Itzapa, Chimaltenango Guatemala
DIAGNOSTIC: Molluscum Contagiosum

Neftaly is a 9-year-old male from San Andrés Itzapa, Guatemala who was evaluated after presenting with a history of skin lesions that had been progressively developing for approximately three months.

According to his mother, the lesions initially appeared on the posterior aspect of the forearm and subsequently spread to the anterior forearm, upper arm, and other areas of the body. The patient also reported itching affecting the upper extremities, chest, and abdomen.

Prior to the medical evaluation, the mother applied Clotriplex cream to the affected areas. A temporary improvement was observed for approximately seven days; however, the lesions subsequently reappeared. No additional medication was administered, and the patient had not been evaluated at another healthcare facility before this consultation.

During the physical examination, multiple clustered papular lesions measuring approximately 2–5 mm were identified. The lesions were elevated, pearly-white in appearance, and presented with a characteristic central depression or punctum. They were observed at different stages of development.

Additionally, whitish lesions were identified in the tonsillar pillar/oropharyngeal region. The patient reported discomfort when taking a deep breath, sore throat/painful swallowing, and decreased appetite associated with odynophagia. The oral lesions require further specialized evaluation to determine their etiology and to rule out other possible causes.

Next Steps

The patient should be referred for pediatric and/or dermatological evaluation to confirm the diagnosis, assess the extent of the lesions, and determine the most appropriate treatment.

The referral should include evaluation of both the cutaneous and oropharyngeal lesions. The specialist should determine whether treatment of the skin lesions is indicated and select the appropriate therapeutic approach based on the patient’s age, number and location of lesions, symptoms, and clinical evolution.

Because of the presence of lesions in the oropharyngeal area accompanied by odynophagia and decreased appetite, further evaluation of these lesions is particularly recommended before attributing them to molluscum contagiosum.

Follow-up should be arranged to monitor the patient’s clinical evolution and response to any treatment prescribed.

Call to Action

Please help us raise funds to help Neftaly to be attended with a correct specialist and get the appropriate treatment for his skin lesions.