Molluscum contagiosum medical therapy
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Molluscum contagiosum Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The mainstay of therapy for molluscum contagiosum is topical treatment. Contemporary topical medical therapies for molluscum contagiosum include cryotherapy, curettage, and topical application of caustic agents.
Medical therapy
Molluscum contagiosum (MC) is a self limited disease. Treatment is often unnecessary[1][2]. The most common chosen treatment method for MC is observational and conservative. Molluscum contagiosum lesions usually resolves spontaneously after 2-6 months with a maximum duration of stay of years. Although it can be resolved spontaneously, it can be a great source of embarrassment and lead to limiting social activity.[3][4][5][6] The range can even be more and extend to a range of durations from 6 months to 5 years.[4][6]
Although there are different treatment options, there is not enough evidence of treatment efficacy for molluscum contagiosum.[7] Health professionals usually recommend to treat genital lesions to prevent them from spreading.[6] Bump treatment doesn't mean the disease is treated as well because the virus is still in the cutaneous tissue and new bumps will often appear even after all the visible ones are surgically treated. As a result, multiple interventional treatment may be needed each time new bumps occur. It is recommended to examine all the body before starting of any topical treatment to determine all visible lesions, in order to decrease the possibility of treatment failure. Usually after a period of time the body can immune itself from the disease but during the immunization, multiple skin lesion may occur which all needed treatment as well.[8][9]
Topical treatment choice
Cryotherapy
- Apply liquid nitrogen with a cotton-tipped swab to the lesion for 6 to 10 seconds.
- It is a rapidly effective therapy [10]
- As it is a painful procedure, its usage is limited in young children
Cantharidin
- It should be applied directly to lesions by physician with a cotton swab [11]
- It should stay on the skin with a bandage and washed off with soap and water 2-6 hours after application or when the first sign of blistering appeared.
- Treatment should be avoided on the face, genital, or perianal areas.
- Associated with some common adverse effects including transient burning, pain, erythema, and pruritus..
Podophyllotoxin
- It is available as an antimitotic agent that is commercially available as podofilox 0.5% (Condylox) in a solution or gel.
- Associated with some common adverse effects including local erythema, burning, pruritus, inflammation, and erosions.
Other less effective treatment choices
Imiquimod
- It is recommended to be applied at night and washed off in the morning, but there are very few data cosidering its efficacy.
Potassium hydroxide
- 5 or 10% dose concentration can be used for treatment of lesions, but there are very few data cosidering its efficacy
References
- ↑ Prodigy knowledgebase (2003). "Molluscum Contagiosum". National Health Service. Retrieved 2006-07-06. Unknown parameter
|month=ignored (help) - UK NHS guidelines on Molluscum Contagiosum - ↑ van der Wouden JC, Menke J, Gajadin S; et al. (2006). "Interventions for cutaneous molluscum contagiosum". Cochrane Database Syst Rev (2): CD004767. doi:10.1002/14651858.CD004767.pub2. PMID 16625612.
- ↑ Weller R, O'Callaghan CJ, MacSween RM, White MI (1999). "Scarring in Molluscum contagiosum: comparison of physical expression and phenol ablation". BMJ. 319 (7224): 1540. PMID 10591712.
- ↑ 4.0 4.1 derm/270 at eMedicine
- ↑ MedlinePlus Encyclopedia 000826
- ↑ 6.0 6.1 6.2 Tyring SK (2003). "Molluscum contagiosum: the importance of early diagnosis and treatment". Am. J. Obstet. Gynecol. 189 (3 Suppl): S12–6. PMID 14532898.
- ↑ van der Wouden JC, van der Sande R, van Suijlekom-Smit LW, Berger M, Butler CC, Koning S (2009). "Interventions for cutaneous molluscum contagiosum". Cochrane Database Syst Rev (4): CD004767. doi:10.1002/14651858.CD004767.pub3. PMID 19821333.
- ↑ Hanna D, Hatami A, Powell J, Marcoux D, Maari C, Savard P, Thibeault H, McCuaig C (2006). "A prospective randomized trial comparing the efficacy and adverse effects of four recognized treatments of molluscum contagiosum in children". Pediatr Dermatol. 23 (6): 574–9. doi:10.1111/j.1525-1470.2006.00313.x. PMID 17156002.
- ↑ "Molluscum Contagiosum - Treatment Overview". WebMD. January 12, 2007. Retrieved 2007-10-21.
- ↑ Al-Mutairi N, Al-Doukhi A, Al-Farag S, Al-Haddad A (2010). "Comparative study on the efficacy, safety, and acceptability of imiquimod 5% cream versus cryotherapy for molluscum contagiosum in children". Pediatr Dermatol. 27 (4): 388–94. doi:10.1111/j.1525-1470.2009.00974.x. PMID 19804497.
- ↑ Coloe J, Morrell DS (2009). "Cantharidin use among pediatric dermatologists in the treatment of molluscum contagiosum". Pediatr Dermatol. 26 (4): 405–8. doi:10.1111/j.1525-1470.2008.00860.x. PMID 19689514.