Molluscum Contagiosum In Children Research Articles

Comprehensive Review of Molluscum Contagiosum in Children: Prevalence, Transmission, Clinical Features, and FDA-Approved Treatments

Background: Molluscum contagiosum (MC) is a common viral skin infection affecting school-aged children, with a prevalence of 2-8%. Although self-limited, MC often requires active management to prevent spread, scarring, and to address cosmetic and social concerns. Traditional treatments have various complications, and currently, only topical berdazimer gel and cantharidin are approved by the FDA. Methods: A comprehensive literature review was conducted to assess the prevalence, transmission, clinical presentation, complications, and treatment options for MC. The review included studies from various geographic regions, focusing on both physical and chemical treatment methods, as well as newer FDA-approved therapies. Results: MC is most prevalent in children aged 2-5, with no gender-specific differences. The infection manifests as skin-colored, dome-shaped papules, primarily on exposed skin. Complications include school exclusion, social isolation, and secondary infections. Treatment options vary widely in efficacy and safety. Physical treatments like curettage and cryotherapy are effective but can cause scarring and discomfort. Chemical treatments, including potassium hydroxide and cantharidin, offer non-invasive alternatives but have side effects. Newer treatments like topical berdazimer gel and cantharidin solution are promising due to their ease of use and lower complication rates. Conclusion: MC is a significant infection in children, often necessitating treatment due to its complications. While traditional treatments have notable drawbacks, FDA-approved topical therapies, berdazimer gel, and cantharidin, provide effective and safer options. Further research is needed to optimize treatment protocols and minimize adverse effects.

Demographic and clinic characteristics and risk factors of molluscum contagiosum in children.

To address the gap in evidence related to molluscum contagiosum in children by focusing on demographic and clinical features as well as risk factors. The multicentre, prospective, clinical study was conducted at four hospitals in Ankara and Tokat cities of Turkey from August 1, 2014, to August 5, 2019, and comprised patients aged ≤18 years diagnosed with molluscum contagiosum. Data about demographics, day nursery and preschool attendance, the seasons when the disease occurred, any use of Turkish baths and swimming pools, history of personal/familial atopy, coexistence of diseases, disease duration, courses, number of lesions and anatomic localisation. Data was analysed using SPSS 19. Of the 286 patients, 130(45.5%) were girls and 156(54.5%) were boys. The overall mean age was 5.94±3.95 years. The median duration of the disease was 5 weeks (interquartile range: 3.00-12.00 weeks). There was a significant number of cases with family history 18(48.6%) in the 0-3 age group (p=0.027). History of personal atopy was significantly high in the winter season (p<0.05). Patients with >20 lesions had used swimming pools significantly more frequently than the rest (p=0.042). The trunk was the most commonly involved region 162(56.6%). Providing prospective data about demographics, clinical characteristics and risk factors of molluscum contagiosum in children will lead to appropriate preventive and therapeutic measures.

Abnormal cutaneous reaction to potassium hydroxide in molluscum contagiosum in children.

Abnormal cutaneous reaction to potassium hydroxide in molluscum contagiosum in children.

Oral Isotretinoin in the Treatment of Recalcitrant Molluscum Contagiosum in Children

Background:Recalcitrant molluscum contagiosum in children has been treated with many destructive procedures with a high recurrence rate, alternative treatments would be desirable in pediatric patients. Oral isotretinoin has been used to treat viral warts successfully in children. Aim of the work: Our aim in this study wasto investigate the influence of oral isotretinoin in MC patients. Methods: Twenty children less than 18 years, with recalcitrant molluscum contagiosum were enrolled in this study, the treatment protocol was oral isotretinoin [0.5 mg/kg] daily until complete clearance [maximum duration 3 months]. Patients were evaluated clinically and photographically every two weeks to assess the response to treatment and to report side effects of therapy. Patients with complete response were followed up monthly for three months to record the recurrence rate. Lipid profile [Triglycerides, cholesterol, LDL and HDL] and liver function tests [SGOT and SGPT] were performed before treatment and every 4 weeks during the treatment period. Results:Mean age of participants was 12.90 ± 2.64 years, 80% of them were more than 10 years old, [65%] were male, and the mean weight of studied cases was 49.10 ± 15.33 kg. The face was most common affected site in most cases [45%]. The mean lesion size was 2.63 ± 1.11 mm, and mean number of molluscum lesions of 23.55 ± 12.85. As regarding to recurrence rate, 93.8% of cases who had complete response were still free at the end of 3 months follow up and only 6.3% had recurrence. Reported side effects were dry lips in all participants, 55% had a dry skin and 30% had a dry nose. Conclusion: Oral isotretinoin therapy improves recalcitrant MC lesions in children, which maycontribute to its therapeutic efficacy.

Abnormal cutaneous reaction to potassium hydroxide in molluscum contagiosum in children: an observational study on 8 patients

article: Abnormal cutaneous reaction to potassium hydroxide in molluscum contagiosum in children: an observational study on 8 patients - Giornale Italiano di Dermatologia e Venereologia 2020 Oct 16 - Minerva Medica - Journals

Childhood molluscum contagiosum treated with 585 nm pulsed dye laser: a clinical observation

Objective To evaluate the efficacy and safety of 585 nm pulsed dye laser for the treatment of molluscum contagiosum in children. Methods Between September 2016 and February 2017, 50 children with confirmed molluscum contagiosum were enrolled from Maternal and Child Health Care Hospital of Zibo. These children were treated with 585 nm pulsed dye laser at energy of 6.0 - 9.0 J/cm2, pulse width of 0.5 ms and spot size of 5 mm. If a patient was not cured after 1 session of the laser treatment, another session of the laser treatment would be performed 1 month after the first treatment. If the proportion of regressed skin lesions was less than 30% after more than 2 consecutive sessions of the laser treatment, the treatment would be stopped. After the treatment, the patients were followed up for 6 months. During the follow-up, clinical efficacy was evaluated according to regression of skin lesions, and adverse reactions and recurrence were recorded. Results All the patients completed the trial. After the treatment, 44 (88%) patients were cured, and the response rate was 94% (47/50) . After 1 session of the treatment, 32 (64%) patients were cured. After the laser treatment, purpura occurred instantly, hyperpigmentation and hypopigmentation occurred in a short-term period, and no obvious long-term adverse reactions were observed. During the follow-up, no new wart was found at the site of regressed warts after the treatment. Conclusion The 585 nm pulsed dye laser shows good efficacy, safety and tolerance in the treatment of molluscum contagiosum. Key words: Lasers, dye; Treatment outcome; Adverse reactions; Molluscum contagiosum

Oral ranitidine: A promising novel therapeutic option in molluscum contagiosum in children

Background: Molluscum contagiosum(MC) is one of the most common cutaneous viral infection observed in children. Though, it is benign and self-limiting, treatment is often sought for cosmetic reasons. Existing invasive therapeutic modalities are generally not well tolerated in children because of pain and risk of scarring. Immunomodulatory potential of cimetidine is well established. We thus extrapolated the same to ranitidine and conducted this study. Aim: To assess the efficacy of oral ranitidine in treatment of molluscum contagiosum in immunocompetent children. Methods: A multicentre longitudinal study was conducted in the dermatology departments of tertiary care hospitals in Ahmedabad and Wardha, India over a period of 4 months. 24 children with MC were included. Oral ranitidine was started in dose of 5 mg/kg/day in two divided doses for 8 weeks. Follow up was done very 15 days and changes in number and size of lesions were noted. Results: Mean age of patients was 5.08 years. 19 patients completed the study. 15 patients had improvement in the lesions at the end of 8 weeks while 4 patients did not show any improvement. Complete clearance was seen in 14 patients(73.6%) and 1 patient had decrease in size of the lesions without change in the number. Mean duration of complete clearance of lesion was 6.5 weeks. Conclusion: Oral ranitidine may be considered as a safe and effective alternative therapeutic option in widespread MC in immunocompetent children where invasive painful procedures are less desirable.

Update on the Treatment of Molluscum Contagiosum in Children

Molluscum contagiosum is one of the most common viral infections in childhood. It is a benign and usually self-limiting infection, but its treatment in children can be challenging, particularly when the patient presents multiple lesions or when lesions are symptomatic or highly visible. Several treatment options exist. Choice of treatment depends on the number and location of lesions, the prior experience of the treating physician, and the preferences of the child's parents or carers. This article provides an update on treatment options for molluscum contagiosum, with a particular focus on immunocompetent pediatric patients.

Cantharidin: A well-tolerated and effective therapy for Molluscum contagiosum in children

Molluscum contagiosum (MC) is a frequent viral infection in paediatric population. Destructive therapies for MC are poorly tolerated in children, so in this study, we have assessed the efficacy and tolerability of a non-painful treatment intervention with topical cantharidin. A prospective case series was conducted in which 30 pediatric patients were recruited. Diagnosis of MC was made by dermatologist. Cantharidin collodion 0.2% was applied by dermatologist in an office setting, with a follow-up at 2 and 4 wk. Patients were evaluated about their experience with cantharidin and other treatments for MC (if they had been treated before). Pain experienced with cantharidin technique was measured using a visual analog scale called Faces Pain Rating Scale. The results of this prospective study have demonstrated that cantharidin could be considered a front line therapy for MC in children.

Dermatologists, imiquimod, and treatment of molluscum contagiosum in children: righting wrongs.

“Halfofwhatwe’reteachingyouiswrong,”oneofmymedical school deans would often say. “The problem,”hewouldcontinue,“isthatwedon’tknowwhichhalf.”The dean was wise. Consider the case of imi-quimod, long widely considered beneficial for treat-mentofmolluscumcontagiosum.Itactuallyisnot,as2large randomized clinical trials (RCTs) showed.

Time to resolution and effect on quality of life of molluscum contagiosum in children in the UK: a prospective community cohort study

Molluscum contagiosum is one of the 50 most prevalent diseases worldwide, but scarce epidemiological data exist for childhood molluscum contagiosum. We aimed to describe the time to resolution, transmission to household child contacts, and effect on quality of life of molluscum contagiosum in children in the UK. Between Jan 1, and Oct 31, 2013, we recruited 306 children with molluscum contagiosum aged between 4 and 15 years in the UK either by referral by general practitioner or self-referral (with diagnosis made by parents by use of the validated Molluscum Contagiosum Diagnostic Tool for Parents [MCDTP]). All participants were asked to complete a questionnaire at recruitment about participant characteristics, transmission, and quality of life. We measured quality of life with the Children's Dermatology Life Quality Index (CDLQI). Participants were prospectively followed up every month to check on their recovery from molluscum contagiosum and transmission to other children in the same household, until the child's lesions were no longer visible. The mean time to resolution was 13·3 months (SD 8·2). 80 (30%) of 269 cases had not resolved by 18 months; 36 (13%) had not resolved by 24 months. We recorded transmission to other children in the household in 102 (41%) of 250 cases. Molluscum contagiosum had a small effect on quality of life for most participants, although 33 (11%) of 301 participants had a very severe effect on quality of life (CDLQI score >13). A greater number of lesions was associated with a greater effect on quality of life (H=55·8, p<0·0001). One in ten children with molluscum contagiosum is likely to have a substantial effect on their quality of life and therefore treatment should be considered for some children, especially those with many lesions or who have been identified as having a severe effect on quality of life. Patients with molluscum contagiosum and their parents need to be given accurate information about the expected natural history of the disorder. Our data provide the most reliable estimates of the expected time to resolution so far and can be used to help set realistic expectations. Wales School of Primary Care Research (WSPCR) and Cardiff University.

The natural history of molluscum contagiosum in children

The natural history of molluscum contagiosum in children

Контагиозный моллюск в практике детского хирурга

В работе представлены сведения о контагиозном моллюске у детей. Контагиозный моллюск — доброкачественное заразное заболевание кожи, возникающее при контакте с больным человеком. Возбудителем является патогенный эпидермотропный вирус (Мolluscum contagiosum virus). В клинике детской хирургии им. проф. Н.Л. Куща за последние 15 лет (1997–2012 гг.) лечилось 116 детей по поводу контагиозного моллюска в возрасте от 8 месяцев до 16 лет. Лиц женского пола было 60 (51,7 %), мужского пола — 56 (48,3 %). Основную группу пациентов (около 70 %) составили больные в возрасте от 2 до 5 лет. Давность заболевания варьировала от нескольких недель до 4–6 месяцев. Диагноз заболевания устанавливали после изучения элементов сыпи с последующей патогистологической верификацией. При наличии нетипичных или сомнительных опухолеподобных образований диагноз контагиозного моллюска устанавливался только после гистологического исследования. В случаях типичных элементов сыпи диагноз контагиозного моллюска до оперативного лечения был выставлен у 102 детей. У остальных больных (14 пациентов) не исключалось также наличие папилломы, бородавки или дерматофибромы. Удаление контагиозного моллюска наблюдаемым детям проводилось методом диатермокоагуляции (электрокоагуляции) опухолеподобных узелков с тщательным удалением содержимого с последующей обработкой спирто-йодной настойкой. В обязательном порядке проводили патогистологическое исследование удаленных тканей моллюска. При единичных элементах использовали местный анестетик путем предварительного нанесения крема ЭМЛА (22 ребенка) за 30–40 минут до манипуляции. У оставшихся больных применяли общую кратковременную анестезию. Осложнений не наблюдали. Рецидивы заболевания имели место у 6 детей. После повторной диатермокоагуляции наступило выздоровление. Всем детям, независимо от места дальнейшего лечения, по показаниям назначались системная противовирусная терапия, поливитамины, пробиотики, иммуномодуляторы. Доказаны доступность и высокая эффективность лечения. Больного, у которого диагностирован контагиозный моллюск, изолируют от детского коллектива до полного выздоровления. Профилактика контагиозного моллюска заключается в своевременном выявлении инфекции и соблюдении правил личной гигиены. Выводы. Диатермокоагуляция контагиозного моллюска у детей является простым, доступным и эффективным методом лечения. Больные с контагиозным моллюском нуждаются в изоляции. После отпадения корочек в местах диатермокоагуляции дети могут посещать детский сад или школу.

Comparative study of 5% and 2.5% potassium hydroxide solution for molluscum contagiosum in children

Background: Molluscum contagiosum (MC) is a pediatric viral infection that is fairly contagious. Although various treatment methods are available, the presence of facial lesions limits options of therapy.Aim: We aimed to test an alternative treatment consisting of application of two different concentrations of potassium hydroxide (of KOH 5% solution and of KOH 2.5% solution) aqueous solution.Methods: In this study we evaluated the effectiveness and side-effects of daily applications of potassium hydroxide (KOH) aqueous solution at 2.5% and 5% concentrations, twice daily in 29 children with MC. Out of a total of 29 patients with molluscum contagiosum included in the study, 13 patients in the 2.5% KOH group and 12 patients in the KOH 5% group completed the study. Families were instructed to apply potassium hydroxide twice a day. The assessment of response and side-effects were performed on days 0, 15, 30, 45 and 60 (visits were numbered 1, 2, 3, 4 and 5, respectively) and one month after.Results: We had a total of 11 (44%) patients who completely recovered after the fifth visit. While eight (66.7%) of these 11 patients were in the 5% treatment group, three (23.1%) patients were in the 2.5% treatment group, and there was a statistically meaningful difference (p < 0.047). Patients with fewer lesions remitted better (p < 0.05). When number of lesions were taken into consideration, difference between the two treatment groups appeared after the fourth visit (p < 0.001). There were no statistical differences between the two groups with respect to side-effects (p = 0.682).Conclusions: Potassium hydroxide solution at a concentration of 5% was more effective than 2.5% in our patients. The treatment was well-tolerated on the face with the advantage of administration of lower concentrations. This study suggests potassium hydroxide may be a more preferable mode of treatment for molluscum contagiosum lesions on the face.

Molusco contagioso - Intervenção terapêutica na idade pediátrica. Revisão baseada na evidência

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.

Comparative Study of 5 % Potassium Hydroxide Solution Versus 0.05% Tretinoin Cream for Molluscum Contagiosum in Children

Molluscum contagiosum is one of the commonest cutaneous viral infections in children. All treatment modalities are associated with substantial pain, tissue destruction, and frequent recurrence. To compare the efficacy and side effects of KOH 5% solution with tretinoin 0.05% cream for the treatment of molluscum contagiosum in children. Fifty patients were randomly divided into 2 groups; 25 each for 5% KOH solution and 0.05% tretinoin cream. The given medication was applied at bed time over molluscum lesions. The assessment of response and side effects were performed weekly for 4 weeks. At the end of 4 weeks, the mean lesion count decreased from 9.48 +/- 3.00 SD to 1.67 +/- 0.58 SD and from 8.35 +/- 2.82 SD to 2.00 +/- 1.00 SD in patients treated with 5% KOH solution and 0.05% tretinoin cream respectively. The result of both KOH and tretinoin showed good response, well tolerated by children but between the two, KOH showed fast recovery and most lesions were resolved before 4 week. The side effects could be minimized if applied as stated above. On the other hand, tretinoin showed delayed response and even some of lesion extended beyond 4 week but the side effect were less, and hence can be used in recurrent cases.

An open, comparative study of 10% potassium hydroxide solution versus salicylic and lactic acid combination in the treatment of molluscum contagiosum in children

Objectives: To evaluate and compare the safety and efficacy of 10% potassium hydroxide (KOH) solution and salicylic and lactic acid (SAL + LAC) combination in the treatment of molluscum contagiosum (MC). Material and methods: 26 patients with MC randomized into two treatment groups. 12 patients treated with 10% KOH solution and 14 patients treated with SAL + LAC combination for 6 weeks. Parents of patients were instructed to apply medication once daily only to lesions at study onset. Assessment of response of the treated lesions and side effects was performed at 2, 4 and 6 weeks of the treatment. Newly acquired lesions were not included in the study. Results: At the end of therapy, 83.3% (n = 10) of KOH group demonstrated complete remission and 16.7% (n = 2) of them showed partial remission; four patients (33%) developed new lesions during the study. All the patients in the SAL + LAC combination group (100%) demonstrated complete remission of study entry lesions at the end of 6 weeks with five patients (35%) acquiring new lesions during the study. Minor side effects were observed in two groups. Conclusions: 10% KOH solution and SAL + LAC combination were found to be equally effective in the treatment of MC in children.

Intralesional Immunotherapy with Candida Antigen for the Treatment of Molluscum Contagiosum in Children

Intralesional Immunotherapy with Candida Antigen for the Treatment of Molluscum Contagiosum in Children

Clinical Characteristics of Molluscum Contagiosum in Children in a Private Dermatology Practice in the Greater Paris Area, France: A Prospective Study in 661 Patients

Background: Series regarding the clinical characteristics of molluscum contagiosum (MC) are retrospective and concern small defined populations seen in a hospital setting. Methods: We prospectively studied patients under 15 years of age with MC seen in 25 private dermatology practices in the greater Paris area during 1 year. Results: Six hundred fifty patients were included. The mean age was 6 years. Of the patients, 30.5% had had MC in the past, 53% had 5–20 MC, 43% had a history of atopic dermatitis (AD), 5% were using topical steroids, 25.5% had coexistent AD, 13% had giant MC (>5 mm), 21% had inflammatory MC, and 19% had MC surrounded by eczema. Bathing with siblings was associated with a higher number of MC. A history of AD was associated with the presence of MC surrounded by eczema. The use of topical steroids was associated with a higher risk of relapse. There was no relation between environmental factors (MC in surrounding people, going to the swimming pool, sports practice) and the number of lesions or between environmental factors and the number of recurrences. Conclusion: Atypical lesions are frequent. Bathing with siblings is associated with a higher number of MC. Topical steroid use increases the risk of relapses. AD prevalence is higher than in the general population.

Intralesional Immunotherapy with Candida Antigen for the Treatment of Molluscum Contagiosum in Children

Intralesional injection of Candida and other antigens is an established and useful therapy for warts; a cutaneous immune response can induce improvement and or clearance of warts, often with response in anatomically distinct lesions other than those injected. Molluscum contagiosum virus is a common cutaneous infection seen primarily in pediatric dermatology clinics. Treatment is often unsatisfactory, painful, and time consuming. A retrospective chart review was conducted to examine the efficacy of intralesional injection of Candida antigen into a maximum of three individual molluscum lesions. Twenty-nine patients were treated with this therapy; 55% had complete resolution. In addition, 37.9% experienced partial resolution, yielding an overall response rate of 93%. Only two patients failed to respond (6.9%). In addition, only four patients reported a single adverse effect of pain with injection. No other adverse effects were reported or noted clinically. Scarring was absent. No recurrences were reported at the time of publication. This report establishes the efficacy of intralesional injection of Candida for molluscum contagiosum.