Monday, December 21, 2015

Treatment of Molluscum Contagiosum

  • It is a common viral skin infection of childhood that causes localised clusters of epidermal papules called mollusca
  • No best treatment since we are currently unable to kill the virus. The viral lesion will eventually resolve on its own. In many cases no specific treatment is necessary. Treatment is usually for cosmetic reasons
  • The papules may persist for 6 months or up to 2 years or longer. In children, about half of cases have cleared by 12 months, and two-thirds by 18 months, with or without treatment
First-line therapy
Cryotherapy (freezing agent)
Curettage (physical removal)
Cantharidin (blistering agent)
Podophyllotoxin cream (antimitotic agent)
Other alternatives
Topical-
Imiquimod
Potassium hydroxide
Salicylic acid
Topical retinoid (tretinoin, adapalene)
Other topical agents (silver nitrate paste, topical phenol, trichloroaccetic acid)
Oral-cimetidine (40mg/kg/day-efficacy is uncertain
Other physical therapy-Laserablation

Availability: Salicylic acid ointment (2-10%, 20%)

Recommendations
  • Apply salicylic acid ointment 10% to the lesion 3 times/week, and continue 1-2 weeks after lesion resolves.
  • There is no study on duration but based on treatment for warts, should see improvement in 2 to 3 weeks.
  • Increase concentration if there is not improvement in 4 weeks if necessary.

References:
  1. http://www.dermnetnz.org/viral/molluscum-contagiosum.html
  2. http://www.uptodate.com.ezp.imu.edu.my/contents/molluscum-contagiosum?
  3. http://hiv.uw.edu/derm/case5/discussion.html

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