INTRODUCTION
Molluscum contagiosum (molluscum) is the third most common viral skin infection in children and one of the five most prevalent skin diseases worldwide.1,2 Molluscum primarily affects children, the immunocompromised, and sexually active adults,3 with the greatest incidence in children between the ages of 1 and 14.4 While prevalence rates vary widely in the literature, best estimates range between 5.1% and 11.5%.5
Frequently described as “benign†and “self-limiting,†molluscum is often perceived as a mild, short-lived illness that can be waited out. This perception is being challenged as new data about prognosis and impact on quality of life become available. The largest cohort study to date found that, not only was the average duration of illness more than a year, but, for a subpopulation of molluscum patients, especially those with larger numbers of lesions and those with higher CDLQI scores, the impact on quality of life was significant.4
Despite identification of molluscum nearly two centuries ago,3 as of this writing, there are no treatments approved by the U.S. Food and Drug Administration (FDA),1 nor is there consensus on the optimal treatment paradigm. While several excellent reviews of treatment options for molluscum have been published recently,6-9 clinical guidance remains limited in the United States. The goal of this review was to collect and summarize both evidence- and experience-based information about treatments and considerations for special clinical presentations.
To this end, a group of pediatric and adult dermatologists widely recognized for their expertise in treating molluscum contagiosum convened to collectively discuss their treatment approaches. In Part I, the group identified seven therapies used frequently today and provided insights gained from their decades of experiences. In Part II, the group identified and discussed the key considerations for five clinical presentations frequently encountered when treating patients with molluscum.
Frequently described as “benign†and “self-limiting,†molluscum is often perceived as a mild, short-lived illness that can be waited out. This perception is being challenged as new data about prognosis and impact on quality of life become available. The largest cohort study to date found that, not only was the average duration of illness more than a year, but, for a subpopulation of molluscum patients, especially those with larger numbers of lesions and those with higher CDLQI scores, the impact on quality of life was significant.4
Despite identification of molluscum nearly two centuries ago,3 as of this writing, there are no treatments approved by the U.S. Food and Drug Administration (FDA),1 nor is there consensus on the optimal treatment paradigm. While several excellent reviews of treatment options for molluscum have been published recently,6-9 clinical guidance remains limited in the United States. The goal of this review was to collect and summarize both evidence- and experience-based information about treatments and considerations for special clinical presentations.
To this end, a group of pediatric and adult dermatologists widely recognized for their expertise in treating molluscum contagiosum convened to collectively discuss their treatment approaches. In Part I, the group identified seven therapies used frequently today and provided insights gained from their decades of experiences. In Part II, the group identified and discussed the key considerations for five clinical presentations frequently encountered when treating patients with molluscum.
