Efficacy of 5% Imiquimod cream in the treatment of Molluscum contagiosum compare with extraction method

Patchanee Tohtubtiang

Authors

Patchanee Tohtubtiang SURGERY AND LASER DEPARTMENT, TRANG REGIONAL CENTER OF TROPICAL DERMATOLOGY, THAILAND

Keywords:

Molluscum contagiosum, 5% Imiquimod cream, Molluscum extraction

Abstract

Background: Most lesions of Molluscum Contagiosum (MC) resolve spontaneously. The treatment may be needed when itching or cosmetic problem were concerned. The conventional treatment is extraction under local anesthesia but adverse consequence such as painful, hyperpigmentation and scar were frequently inevitable. Imiquimod, an immune response modifier used for viral skin infection has been claimed to be an efficacious treatment of MC.

Objective: To study the efficacy of 5% Imiquimod cream compare with conventional extraction method in the treatment of molluscum contagiosum.

Method: 104 MC patients were divided into 2 groups with no difference in age, number of initial lesions, and duration of disease. The efficacy of treatment was compared between 2 groups.

Result: At 1^st, 2^nd, and 3^rd months of follow up, 53.8%, 90.4% and 96.2% of patients who received extracted treatment showed complete response respectively. On the contrary, 13.5%, 23.1%, and 40.4% of Imiquimod treated patients show complete response after 1^st, 2^nd and 3^rd months follow up respectively . Side effects included, pain in 57.7%

and scar in 38.5% after extraction method. While Imiquimod group show only redness and itching as their adverse reaction.

Conclusion: This extraction method is an efficacious treatment for MC. Imiquimod may be used as an alternative treatment in small children in order to minimized pain.

References

Theos AU, Cummins R, Silverberg NB, Paller AS. Effectiveness of imiquimod cream 5% for treating childhood molluscum contagiosum in a double-blind, randomized pilot trial. Cutis 2004; 74:134-42.

Gottlieb SL, Myskowski PL. Molluscum Contagiosum. International Journal of Dermatology 1994; 33: 453-61.

Cribier B, Scrivener Y, Groosshans E. Molluscum Contagiosum : Histologic Patterns and Associated Lesions. Am J Dermatopathol 2001; 23: 99-103.

Leslie KS, Dootson G, Sterling JC. Does treatment of molluscum contagiosum affect clearance?. Br J Dermatol 2004; 151: 67-8.

Syed TA, Goswami J, Ahmadpour OA , Ahmad SA. Treatment of molluscum contagiosum in males with an analog of imiquimod 1% in cream: a placebo-controlled, double-blind study. J Dermatol 1998; 25: 309-13.

Barba AR, Kapoor S, Berman B. An open label safety study of topical imiquimod 5% cream in the treatment of molluscum contagiosum in children. Dermatology Online Journal 2001; 7: 20.

Dohil MA, Lin P, Lee J, Lucky AW, Paller AS, Eichenfield LF. The epidemiology of molluscum contagiosum in children. J Am Acad Dermatol 2006; 54: 47-54.

Van der Wouden JC, Menke J, Gajadin S, et al. Interventions for cutaneous molluscum contagiosum (Review). The Cochrane Collaboration 2006; 2: 1-22.

Bikowski JB Jr. Molluscum contagiosum: the need for physician intervention and new treatment options. Cutis 2004; 73: 202-6.

Hanson D, Diven DG. Mulluscum Contagiosum. Dermatology Online Journal 2003; 9: 2.

Weller R, O’Callaghan CJ, MacSween RM, White MI. Scarring in molluscum contagiosum: comparison of physical expression and phenol ablation. BMJ 1999; 319: 1540.

Hengge UR, Cusini M. Topical immunomodulators for the treatment of external genital warts, cutaneous warts and molluscum contagiosum. Br J Dermatol 2003; 149 Suppl 66: 15-9.

Hengge UR, Esser S, Schultewolter T, et al. Self-administered topical 5% imiquimod for the treatment of common warts and molluscum contagiosum. Br J Dermatol 2000; 143: 1026-31.

Skinner RB Jr. Imiquimod. Dermatol Clin 2003; 21 : 291-300.

Dockrell DH, Kinghorn GR. Imiquimod and resiquimod as novel immunomodulators. Journal of Antimicrobial Chemotherapy 2001; 48: 751-5.

Berman B, Hengge U, Barton S. Successful management of viral infections and other dermatoses with imiquimod 5% cream. Acta Derm Venereol Suppl (Stockh) 2003; 214: 12-7.

Skinner RB Jr. Treatment of molluscum contagiosum with imiquimod 5% cream. J Am Acad Dermatol 2002; 47: S221-4.

Bayerl C, Feller G, Goerdt S. Experience in treating molluscum contagiosum in children with imiquimod 5% cream. Br J Dermatol 2003; 149: 25-8.

Edwards L. Imiquimod in clinical practice. J Am Acad Dermatol 2000; 43: S12-7.

Foss GL, Orchard DC. Combination topical treatment of molluscum contagiosum with cantharidin and imiquimod 5% in children: A case series of 16 patients. Australasian Journal of Dermatology 2004; 45: 100-102.

Silverberg NB, Sidbury R, Mancini AJ. Childhood molluscum contagiosum: experience with cantharidin therapy in 300 patients. J Am Acade Dermatol 2000; 43:503-7.

Romiti R, Ribeiro AP, Grinblat BM, Rivitti EA, Romiti N. Treatment of molluscum contagisum with potassium hydroxide: a clinical approach in 35 children. Pediatr Dermatol 1999; 16: 228-3.

Papa CM, Berger RS. Venereal herpes-like molluscum contagiosum: treatment with tretinoin. Cutis 1976; 18:537-40.

Syed TA, Lundin S, Ahmad M. Topical 0.3% and 0.5% podophyllotoxin cream for self- treatment of molluscum contagiosum in males.A placebo-controlled, double blind study. Dermatol 1994; 189:65-8.

Ohkuma M. Molluscum contagiosum treated with iodine solution and salicylic acid plaster. Int J Dermatol 1990; 29: 443-5.

Avella, J, Madsen JE, Binder HJ, Askenase PW. Effect of histamine H2-receptor antagonists on delayed hypersensitivity. Lancet 1978; 1:624-6.

Dohil M, Prendiville JS. Treatment of molluscum contagiosum with oral cimetidine: clinical experience in 13 patients. Pediatr Dermatol 1996; 13:310-2.

Cunningham BB, Paller AS, Garzon M. Inefficacy of oral cimetidine for non-atopic children with molluscum contagiosum. Pediatr Dermatol 1998; 15:71-2.

Yashar SS, Shamiri B. Oral cimetidine treatment of molluscum contagiosum (letter). Pediatr Dermatol 1999; 16: 493.