Molluscum contagiosum medical therapy
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Molluscum contagiosum Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
Molluscum contagiosum is typically a self-limiting disease and does not require treatment in all patients. Treatment may be provided in cases where the lesions are in a visible location that may be the source of social or psychological distress to the patient (e.g. face, neck, limbs, genitals). In these cases, the mainstay of therapy for molluscum contagiosum is topical treatment. Topical medical therapies for molluscum contagiosum include cryotherapy 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 supportive counseling. Molluscum contagiosum lesions usually resolve spontaneously within 2-6 months with a maximum resolve time that can last for years.[3][4] Although it can resolve spontaneously, it can be a great source of embarrassment and may lead to a limited social activity in some patients.[5][3][4]
Although there are different treatment options, there is not enough evidence of treatment efficacy for molluscum contagiosum.[6] Health professionals usually recommend treatment of genital lesions to prevent them from spreading.[4] Despite local treatment, the virus may still be present, because the virus may still be present in the cutaneous tissue and recurrent lesions will often appear even after all the visible ones are surgically excised. As a result, multiple interventional treatments may be needed each time new lesions appear. It is recommended to examine the whole body before starting of any topical treatment to determine all visible lesions, in order to decrease the possibility of treatment failure. Typically, after a period of time, the body will develop immunity against disease. Until this is achieved, multiple skin lesion may occur.[7]
Cryotherapy
- Apply liquid nitrogen with a cotton-tipped swab to the lesion for 6 to 10 seconds.
- It is a rapidly effective therapy.[8]
- As it is a painful procedure, its usage is limited in young children.
Topical treatment choice
Cantharidin
- It should be applied directly to lesions by physician with a cotton swab.
- 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.
- There are some data establishing associated with some common adverse effects including transient burning, pain, erythema, and pruritus.
Podophyllotoxin
- It is an antimitotic agent that is commercially available as podofilox 0.5% (Condylox) in a solution or gel.
- There are some data establishing associated with some common adverse effects including local erythema, burning, pruritus, inflammation, and erosions.
Other treatment choices
Imiquimod
- It is recommended to be applied at night and washed off in the morning, but there is limited data evaluating its efficacy.
Potassium hydroxide
- Dose concentration of 5 or 10% can be used for treatment of lesions, but there is limited data evaluating 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.
- ↑ 3.0 3.1 derm/270 at eMedicine
- ↑ 4.0 4.1 4.2 Tyring SK (2003). "Molluscum contagiosum: the importance of early diagnosis and treatment". Am. J. Obstet. Gynecol. 189 (3 Suppl): S12–6. PMID 14532898.
- ↑ 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.
- ↑ 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.
- ↑ 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.