Treatments for Molluscum contagiosum: A systematic review.

Viral skin infections (VSIs) were ranked among the top 50 prevalent diseases in 2010. The objective of this study was to determine the epidemiologic features of VSIs in patients attending a dermatology clinic in Egypt from June 2010 to May 2011. Patient's residence, occupation, housing data, and family history of similar conditions were recorded. Categorical data were recorded as frequencies and percentages and were compared by Chi square test. P value < 0.05 was significant. Diagnosis of VSIs was made in 1000/20322 (4.9%) patients. Out of the 1000 patients with VSIs, 580 (58.0%) were residents of rural areas and 420 (42.0%) were residents of urban areas (p = 0.02). Out of the 1000 patients, 489 (48.9%) were females and 511 (51.1%) were males (p = 0.25). The breakdown of 1000 patients with VSIs indicated diagnosis of viral warts in 673 (67.3%), chickenpox (CP) in 200 (20.0%), herpes simplex (HS) facialis in 50 (5.0%), herpes zoster (HZ) in 42 (4.2%), molluscum contagiosum (MC) in 27 (2.7%.0), and anogenital warts in 8 (0.8%) cases. Overcrowding (sharing a bedroom by more than 3 persons) was recorded in 652/1000 (65.2%) of the patients with VSIs [165/200 (82.5.3%) in CP, 36/50 (72%) in HS facials, 427/673 (63.4%) in viral warts, 14/27 (51.9%) in MC, and 10/42 (23.8%) in HZ]. Family history of a similar condition was positive in 329/1000 (32.9%) of the patients with VSIs [142/200 (71.0%) in CP, 177/673 (26.3%) in viral warts, 5/27 (18.5%) in MC, and 4/50 (8%) in HS facialis]. In conclusion, viral warts and CP were the commonest VSIs diagnosed in patients who attended a dermatology clinic in Egypt. Viral skin infections were more prevalent among patients who lived in rural areas and under crowded conditions. These data may have important public health implications particularly in developing countries.

Introduction: Molluscum contagiosum is a viral skin infection most frequently encountered in children between the ages of 2 and 5 years. In most cases the disease is self-limiting and resolves within 6 months to 2 years, but it may persist for up to 5 years. Treatment is given to re- lieve symptoms, to control the spread of lesions, to prevent scarring and secondary infection, and for cosmetic and social reasons. Aim: To assess the evidence for the efficacy and adverse events of treatments for molluscum contagiosum in immunocompetent children. Data sources: Medline, Cochrane Library, Dynamed, National Guideline Clearinghouse and evidence based medicine guidelines. Review methods: We performed a survey of clinical guidelines, systematic reviews, meta-analysis and clinical trials of treatment of mollus- cum contagiosum, published between January 2001 and September 2011, in Portuguese, English, French and Spanish, for children aged 18 years old or younger, using the MeSH term molluscum contagiosum. Exclusion criteria: sexually transmitted molluscum contagiosum and im- munocompromised children. The SORT (Strength of Recommendation Taxonomy) scale of the American Family Physician was used to grade the evidence. Results: Twenty-two studies were found. We selected two guidelines, one systematic review, one Dynamed summary and one randomized clinical trial for this review. There is evidence of efficacy with few adverse effects for topical treatment with Australian lemon myrtle oil or for curettage of lesions (strength of recommendation B). For topical treatments with benzoyl peroxide, imiquimod and cantharidin, the eviden- ce is weaker, as well as for systemic treatment with cimetidine and physical destruction of the lesions with cryotherapy (strength of recom- mendation C). No other evidence-based recommendations can be given for other treatments assessed. Conclusions: There is limited evidence to recommend treatment of molluscum contagiosum in children. Additional well-designed, prospec- tive studies are needed on therapeutic options compared to placebo or watchful waiting. Without good evidence for the efficacy and safety of treatment, watchful waiting must be considered.

Molluscum contagiosum (MC) is a viral skin infection seen in children, sexually active adults and immunocompromised populations. It is usually a self-limiting illness that typically spontaneously resolves without therapeutic intervention....

Molluscum contagiosum is a viral cutaneous infection in childhood that occurs worldwide. Physicians should familiarize themselves with this common condition. To review in depth the epidemiology, pathophysiology, clinical manifestations, complications and, in particular, treatment of molluscum contagiosum. A PubMed search was completed in Clinical Queries using the key term "molluscum contagiosum". Patents were searched using the key term "molluscum contagiosum" from www.google.com/patents, http: //espacenet.com, and www.freepatentsonline.com. Molluscum contagiosum is caused by a poxvirus of the Molluscipox genus. Preschool and elementary school-aged children are more commonly affected. The virus is transmitted by close physical contact, autoinoculation, and fomites. Typically, molluscum contagiosum presents as asymptomatic, discrete, smooth, flesh-colored, dome-shaped papules with central umbilication from which a plug of cheesy material can be expressed. Some authors suggest watchful waiting of the lesions.Many authors suggest active treatment of lesions for cosmetic reasons or concerns of transmission and autoinoculation. Active treatments may be mechanical (e.g. cryotherapy, curettage, pulsed dye laser therapy), chemical (e.g. cantharidin, potassium hydroxide, podophyllotoxin, benzoyl peroxide, tretinoin, trichloroacetic acid, lactic acid, glycolic acid, salicylic acid), immune-modulating (e.g. imiquimod, interferon-alpha, cimetidine) and anti-viral (e.g. cidofovir). Recent patents related to the management of molluscum contagiosum are also retrieved and discussed. These patents comprise of topical compositions and herbal Chinese medicine with limited documentation of their efficacy. The choice of treatment method should depend on the physician's comfort level with the various treatment options, the patient's age, the number and severity of lesions, location of lesions, and the preference of the child/parents. In general, physical destruction of the lesion, in particular, cryotherapy with liquid nitrogen and chemical destruction with cantharidin are the methods of choice for the majority of patients.

Viral skin infections in children encompass a broad spectrum of conditions with diverse clinical manifestations and outcomes. These infections are caused by various viruses, including Herpes Simplex Virus (HSV), Varicella-Zoster Virus (VZV), Human Papillomavirus (HPV), Molluscum Contagiosum, and Coxsackievirus. Each virus presents with unique clinical features and management needs. Herpes Simplex Virus (HSV) infections, which include oral herpes, herpetic whitlow, and eczema herpeticum, present as painful vesicular lesions. HSV-1 typically affects the oral region, while HSV-2 is more common in genital infections. Herpetic gingivostomatitis and eczema herpeticum can cause extensive oral lesions and severe symptoms, requiring antiviral therapy for severe cases. Varicella-Zoster Virus (VZV) causes chickenpox, characterized by a rash that evolves through macules, papules, vesicles, and crusts, often accompanied by fever. Vaccination has significantly reduced the incidence and severity of VZV infections, but severe cases can still occur, particularly in vulnerable populations. Human Papillomavirus (HPV) infections present as warts on various body parts, including common warts, plantar warts, and flat warts. While many HPV warts are self-limiting, persistent or painful warts may require treatment with cryotherapy, topical therapies, or laser therapy. Molluscum Contagiosum, caused by a poxvirus, manifests as dome-shaped, umbilicated papules on the skin. The lesions are generally painless but can cause cosmetic concerns and secondary bacterial infections. Treatments include cryotherapy and topical therapies, though the infection often resolves spontaneously over several months. Coxsackievirus infections are known for causing Hand, Foot, and Mouth Disease (HFMD), presenting with a rash and oral lesions, along with systemic symptoms like fever. Severe manifestations, such as aseptic meningitis and myocarditis, are less common but require specific medical management. Vaccination and early treatment can mitigate severe outcomes and improve quality of life for affected children.

Background: Molluscum contagiosum (MC) is a contagious cutaneous infection caused by MC virus, affecting mainly the pediatric population. It is characterized by flesh-colored umbilicated papules occurring on the skin surface. Potassium hydroxide (KOH) and salicylic acid plus lactic acid combination being keratolytic agents, are effective treatment options. The objective of the study was to compare the efficacy and safety of 10% KOH solution versus salicylic acid/ lactic acid combination in treating Molluscum contagiosum in pediatric population.&#x0D; Material and Methods: A total of 80 children (age range 1-13 years) with Molluscum contagiosum lesions were selected from the Dermatology Out-Patient Department, and were randomly allocated into two groups by lottery method. Group A was given topical 10% KOH solution and group B was given Salicylic plus Lactic acid preparations for topical application. Patients were followed after two weeks to see regression in size of the lesion, and development of any side-effects. Final visit was scheduled at 6 weeks. Statistical analysis was carried out using SPSS (version 16) with p value less than 0.05 considered as statistically significant.&#x0D; Results: Patients with MC (n = 80) were equally divided into group A (treated with 10% KOH) and group B (treated with combination of Salicylic acid and Lactic acid). After 6 weeks, complete remission from Molluscum contagiosum virus was seen in 29 (72.5%) patients of group A and 34 (85%) patients of group B. There were 12 (30%) patients in group A who developed local irritation and 4 (10%) developed local erythema after 6 weeks. None of the patients of group B had any such side effects.&#x0D; Conclusion: 10% KOH solution is as effective as the combination of Salicylic and Lactic acids for treatment of Molluscum contagiosum in pediatric population, however it is associated with side effects of local irritation and erythema.

Introduction Comparative effectiveness data is important in informing regulatory and treatment decisions with information on the clinical significance of the measured outcomes. There is increasing utilization and significance of cardiovascular devices in the United States, thus it is important to know the comparative efficacy of novel cardiovascular devices at the time they receive Food and Drug Administration (FDA) approval. Hypothesis We assessed the hypothesis that clinical trials results submitted to the FDA for approval of novel, high-risk cardiovascular devices often provide comparative efficacy data. Methods Comparative efficacy was defined as the presence of an active control. For all high-risk cardiovascular devices approved by the FDA from 2000 through 2011, we extracted information on comparative efficacy data from Summaries of Safety and Effectiveness Data (Summary) which include study data used to justify FDA approval. All identified studies were examined to determine if they relied upon active controls, historical controls, objective performance criteria, or if they had no control. The proportion of studies containing comparative efficacy data was calculated and cross-tabulated by approval year and device class. A multivariate logistic model was used to assess trends over time and the Kruskal-Wallis test was used to examine differences between device sub-types. Results We examined 114 Summaries which contained 340 cardiovascular device studies. Of these studies, 140 (41%) contained an active control. Historical controls 48 (14%) and objective performance 83 (24%) criteria were commonly used. Sixty-nine (20%) of the studies were single-arm studies without controls. In our Summary-level analysis, 74 (65%) devices had an active control in at least one supporting study. Approval year was not significantly associated with type of control arm after controlling for device type in our multivariate logistic analysis. Use of comparative efficacy data was significantly associated with device type. Use ranged from 15/19 (79%) of hemostasis devices to 0/3 (0%) of ventricular assist devices. Conclusions A minority of studies for the highest risk cardiovascular devices approved by the FDA since 2000 included comparative efficacy data through the use of an active comparator arm. Increasing use of active controls would help to better inform regulatory and treatment decisions at the point of FDA approval.

Preapproval and postapproval availability of published comparative efficacy studies on biological agents approved between 2000 and 2010 was investigated. Approval packages published on the Food and Drug Administration (FDA) website were examined for all biological agents approved between 2000 and 2010 to determine if comparative efficacy studies were available at the time of FDA approval. The availability of comparative efficacy studies published subsequent to approval was determined by searching PubMed for randomized, active-controlled experimental or observational study designs that measured efficacy as the primary endpoint and were relevant to the original FDA-approved indication. From 2000 to 2010, 107 biological agents were approved by FDA. Of the biological agents with alternative treatments, 54.6% had comparative efficacy data available at the time of approval. Although standard-reviewed biological agents were more likely to have comparative efficacy trials included in the FDA approval packages than priority-reviewed biological agents, statistically significant differences are unlikely. Subsequent to approval, 58.1% of biological agents had at least one published comparative efficacy trial, representing a 3.5% absolute increase in the availability of comparative efficacy studies since the time of approval. Vaccines and biological agents in the hematologic diseases, oncology, and miscellaneous diseases classes had fewer published postapproval comparative efficacy studies per agent compared with the overall group of biological agents. Nearly half of all biological agents approved for marketing between 2000 and 2010 lacked publicly accessible, active-controlled efficacy studies at the time of drug approval; a slightly greater proportion of biological agents had comparative efficacy data published subsequent to their approval.

Molluscum contagiosum is a self-healing viral infection of the child. The disease is caused by a DNA pox virus. Its prevalence in the population aged 0 to 16 years ranges between 5.1 and 11.5% (4). However, judging by the fact that the infection disappears spontaneously, does not recur and is exceptional in adults, it is likely that the percentage of children who pass the infection is much higher.Molluscum contagiosum can be associated with different types of inflammation, among which one that affects the individual elements and heralds self-healing, another following the use of caustic agents such as potassium hydroxide (3), a hypersensitivity eczematous dermatitis and finally a dermatitis reminiscent of Gianotti-Crosti syndrome (1).An infectious cellulitis due to molluscum contagiosum has been described in patients with AIDS (2, 4), but not in immunocompetent subjects as in our case.

Is molluscum contagiosum related to zinc deficiency in children? Effectiveness of oral zinc sulfate therapy in lesion regression

Molluscum contagiosum is the most common skin infection in children. One topical treatment used for Molluscum contagiosum ispotassium hydroxide. The objective of this study was to compare the efficacyofpotassium hydroxide topical treatment at different concentrations with that of placebo in terms of complete clearing of Molluscum contagiosum lesions and to assess the safety and tolerance of potassium hydroxide topical treatment. This was a double-blind randomized clinical trial of three treatments (potassium hydroxide 10%, potassium hydroxide 15%, placebo) applied once daily up to complete clearing of lesions (maximum duration 60days) in 53 children aged 2-6years in primary health care pediatric offices in Catalonia, Spain. In the intention-to-treat analysis, potassium hydroxide 10% (58.8%, P=.03) and potassium hydroxide 15% (64.3%, P=.02) had efficacy superior to that of placebo (18.8%). The number of Molluscum contagiosum lesions was significantly reduced with potassium hydroxide 10% and 15%. The main efficacy outcome was achieved in 58.8% of children in the potassium hydroxide 10% group (P=.03 vs placebo) and in 64.3% of children in the potassium hydroxide 15% group (P=.02 vs placebo). Potassium hydroxide 10% and 15% were not significantly different in efficacy from each other. Potassium hydroxide 10% and placebo were better tolerated than potassium hydroxide 15%. No adverse events were reported during the study period. Potassium hydroxide 10% and 15% demonstrated high rates of efficacy in clearing Molluscum contagiosum lesions, with potassium hydroxide 10% being better tolerated.

Various interventions have been applied to treat molluscum contagiosum, but benefits and efficacy remain unclear. To assess the comparative efficacy and safety of interventions for molluscum contagiosum, a network meta-analysis was performed. Embase, PubMed, and the Cochrane Library were searched for articles published between January 1, 1990, and November 31, 2020. Eligible studies were randomized clinical trials (RCTs) of interventions in immunocompetent children and adults with genital/non-genital molluscum contagiosum lesions. Twelve interventions from 25 RCTs including 2,123 participants were assessed. Compared with the placebo, ingenol mebutate had the most significant effect on complete clearance (odds ratio [OR] 117.42, 95% confidence interval [CI] 6.37-2164.88), followed by cryotherapy (OR 16.81, 95% CI 4.13-68.54), podophyllotoxin (OR 10.24, 95% CI 3.36-31.21), and potassium hydroxide (KOH) (OR 10.02, 95% CI 4.64-21.64). Data on adverse effects were too scarce for quantitative synthesis. Ingenol mebutate, cryotherapy, podophyllotoxin, and KOH were more effective than the other interventions in achieving complete clearance, but safety concerns regarding ingenol mebutate have recently been reported. Due to the possibility of spontaneous resolution, observation is also justified for asymptomatic infection. Factors including adverse effects, cost, patient preference, and medical accessibility should be considered.

Background: Wart is a viral skin infection. Its etiological agent is human papilloma virus. It is composed of non-malignant proliferations of keratinocytes. Different regimens have been tried for the treatment of warts. 35% Trichloroacetic acid (TCA) is used conventionally but 10% KOH has shown promising results. Objective: To compare the efficacy of topical 35% Trichloroacetic acid (TCA) versus topical 10% Potassium Hydroxide (KOH) in the treatment of palmoplantar warts in children up to 12 years of age. Methods: A total of 148 cases of palmoplantar warts with age between 3-12 years of either gender were enrolled in the study. These cases were divided into two groups (A and B each having 74 patients). The patients in group A were treated with topical 35% TCA and Group B patients were treated with topical 10% KOH. Patients were followed weekly for 8 weeks for treatment and for further 8 weeks to look for recurrence. Final outcome was seen at 16 weeks. The efficacy was labelled as yes in cases with clearance of all disease lesions. Results: In this study overall patients were 148 with 74 cases in each group. Group A had 36 (48.65%) males and group B had 37 (50%). The mean age in group A was 7.42±2.48 and in group B was 7.81±2.50 years. Group A had 44 (59.46%) cases and group B had 47 (63.51%) cases, with age range of 8-12 years. The efficacy in group A was seen in 28 (37.84%) of cases while in group B it was seen in 57 (77.03%) cases. There were significantly better results seen in group B as compared to group A in terms of efficacy with p= 0.0001. Conclusion: The efficacy of 10% KOH is significantly better than 35% TCA and this difference is again significantly better in terms of all the confounding variables i.e. age, site, size and duration of warts. Keywords: Warts, Human Papilloma Virus, 10% Potassium Hydroxide, 35% Trichloroacetic Acid

Viral skin infections often affect the sports community. The aim of this study was to assess the rates, location sites, and seasons of appearance of common viral cutaneous diseases in beach volleyball athletes in Greece. Five hundred and forty-nine beach volleyball athletes participated in this study. The average age was 28.4 years. The viral infections were herpes simplex (type 1), molluscum contagiosum and warts. The measured parameters included: gender, age, the season when athletes may be more susceptible to infections and the location of infection in the body. Practicing information such as the number of training years, number of weekly trainings, and average hours of daily training was also recorded. Incidence rates correlated in relation to age: (a) warts (p < 0.001), molluscum contagiosum (p < 0.001), and herpes simplex (p = 0.001); (b) years of training: warts (p < 0.001), molluscum contagiosum (p < 0.001), and herpes simplex (p = 0.004); (c) average hours of daily training: molluscum contagiosum (p = 0.006) and herpes simplex (p < 0.010). The skin is the largest organ, and the risk of infection should not be underestimated. Prevention, early detection, recognition, and treatment are related to health and athletic performance, but also to the risk of transmission.

Molluscum contagiosum (MC) is a viral infection of skin and mucous membrane commonly affecting the adolescents and young adults. Extensive lesions are usually common in immunocompromised patients. We herein report a rare case of molluscum contagiosum in an epidermoid cyst (EC) in a 24-year-old immunocompetent male. The provisional clinical diagnosis was inflammed epidermoid cyst or lipoma. On histopathological examination, the lesion displayed a unilocular epidermoid cyst in deep dermis, the lining of which was infected by molluscum contagiosum virus with characteristic inclusions. The overlying epidermis was absolutely normal having no attachment with the cyst.