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4-year-old with 'giant' bumps on eyelids was treated by Pune doctors
Umesh Isalkar,  11 September 2019
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Recently, a four-year-old girl with bubble-shaped bumps on her eyelids, which was obstructing her vision, was successfully treated at a city hospital by use a minimally invasive technique in Pune.

The condition is medically termed as ‘giant molluscums contagiosum’, which are infectious. On 10th August, a team of doctors successfully treated her using the intralesional radiofrequency (high frequency electro surgery) procedure at Columbia Asia Hospital in Kharadi.

The bumps in molluscum contagiosum are generally 2-5mm in size. But, in the girl’s case, they were quite big — 3cmx2cm in size. Consultant dermatosurgeon Kusumika Kanak told TOI, that the surgeons faced with the challenge of avoiding any cosmetic disfigurement and injury to the eyes, along with reducing the cost of treatment. She said that viral and contagious skin infections spread rapidly and especially among children, it can be a difficult task. In this girl’s case, they treated several of giant molluscum through a novel procedure which is both effective and cost-effective. Also, giant molluscum is seen in patients who are immunocompromised. However it is extremely rare to see it in a normal and healthy child like this girl. It was on both upper and lower eyelids.

Speaking on the difference between these skin bumps and rashes seen in measles, Kanak said that molluscum contagiosum forms a colony of virus on the skin, whereas measles and rubella have rashes, similar to those caused by prickly heat. The molluscum does not contain fluid. The virus colony has a thick white appearance and is contagious, therefore, they used the radiofrequency probe in the centre of the lesion first to disinfect the lesion and then debulked it to prevent the spread of the infection.

She further said that laser and other modalities would have been expensive and traditional means are required to needle the molluscums, which was difficult in this case considering the size, hence they planned a newer modality of treatment — intralesional radiofrequency — and performed it under general anaesthesia. The intralesional radiofrequency is a new modality of treatment but proves to be an effective method. Large keloids, lymphangioma circumscriptum, sebaceous adenoma and many other can be treated effectively by intralesional radiofrequency.

The paediatricians and ophthalmologist took good care of the girl pre- and post-operatively. The girl’s parents said that the girl is doing well. The bumps are gone and there is no disfigurement. They also said that due to financial limitations, doctors who treated her waived their fees and it was a very kind gesture from them.

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