Molluscum Contagiosum in Childhood: Treat or Wait?

September 11, 2015

Molluscum Contagiosum in Childhood: Treat or Wait?

  1. Mary Wu Chang, MD

Nearly half of MC infections resolved within 12 months whether lesions were treated or not.

  1. Mary Wu Chang, MD

Molluscum contagiosum (MC), a self-limited, cutaneous infection caused by a pox virus, affects up to 11% of children younger than 16 years. Although MC rarely causes serious complications, it is contagious, it can exacerbate eczema and lead to social stigma, and it may take months or years to resolve.

To provide epidemiologic data on MC in children and to determine the effect of treatment, investigators conducted a retrospective chart review and parental phone survey regarding 170 children aged 15 years or younger (median age, 5 years) who received a diagnosis of MC at an outpatient dermatology clinic. Of these patients, 77% were white; 47% had a history of atopic dermatitis (AD); 2% had a history of immunodeficiency; 35% had fewer than 10 lesions, and 60% had 10 to 49 lesions; and 27% received treatment. Treatments included topical therapies (tretinoin, imiquimod, cidofovir, cimetidine, and cantharidin) and destructive therapies (curettage, cautery, and cryotherapy).

Nearly half of MC infections resolved within 12 months, and approximately 70% resolved within 18 months in both treated and untreated patients; 19% of patients had MC for 24 months or longer. Children with a history of AD had significantly more MC lesions than children without such history, but time to resolution was similar in all children, regardless of AD history, age, sex, race, number of lesions, and extent of infection.

Comment

MC is a common infection of childhood and can be a source of great frustration for parents. These results suggest that time to resolution is probably not affected by treatment or other epidemiologic factors. To avoid dyspigmentation, scarring, and other adverse effects, therapy should be selected according to the age and skin type of the child and the location of the MC. Coexisting eczema should also be treated. Benign neglect is still a reasonable option for many children.

Editor Disclosures at Time of Publication

  • Disclosures for Mary Wu Chang, MD at time of publication Consultant / Advisory board Pierre Fabre; Valeant Speaker’s bureau Pierre Fabre

Citation(s):

Reader Comments (2)

Kimmel, Sanford Physician, Family Medicine/General Practice, Retired

As a family physician and general pediatrician, I can state that few parents are willing to wait the 12 to 18 months for the molluscum contagiosum to clear on its own, especially if new lesions are continually forming. Although I agree that there is no definitive treatment for this condition as each has its share of adverse effects, most parents insist that some treatment be given . Thus the clinician may prescribe that treatment that best suits the situation.

claudio fabian racana Physician, Pediatrics/Adolescent Medicine, swiss medical center

Did you find laringeal respiratory complication ?Wich is your treatement?

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