REVIEW

Treatment of Molluscum Contagiosum in Adult, Pediatric,

and Immunodeficient Populations
Harrison P. Nguyen, Eric Franz, Kelly R. Stiegel, Sylvia Hsu, and Stephen K. Tyring
Background: Molluscum contagiosum is a viral infection of the skin that is widely considered to be a self-resolving disease that
can be treated with benign neglect. However, the clinical reality is that the disease can vary widely by anatomic site and by
recalcitrance to treatment and remains a significant cause of morbidity worldwide.
Objective: The purpose of this review was to compile an updated resource for clinicians that addresses the management of the
broad spectrum of molluscum cases that may be encountered.
Methods: A comprehensive PubMed search was performed to identify publications on the treatment of molluscum infection,
including presentations that may be rare or difficult.
Results: The specific clinical scenario of molluscum must be considered when selecting the optimal therapy because certain
treatments can be more effective for specific patient subpopulations.
Conclusion: Further attention must be directed toward standardizing treatment for molluscum infection based on patient age
and immune status.

OLLUSCUM CONTAGIOSUM is a cutaneous and

mucocutaneous viral infection that is commonly
observed in school-aged children, sexually active adolescents, and immunocompromised individuals of all ages.
The infection is caused by the molluscum contagiosum
virus (MCV), a large double-stranded deoxyribonucleic
acid (DNA) virus from the Poxviridae family. The MCV
genome is covalently linked at both ends and encodes
several gene products that are involved in both viral life
cycle and host immune evasion.13 In otherwise healthy
patients, MCV infection presents as a small cluster (1120)
of skin-colored papules that are 3 to 5 mm in diameter.4
Molluscum papules are clinically differentiated from
lesions formed by other cutaneous diseases by the presence
of a central umbilication. However, this defining feature
may be difficult to empirically observe in a variety of
clinical scenarios and, instead, may bear an appearance
similar to an acneiform eruption. Generally, the papules

From the Department of Dermatology, Baylor College of Medicine,

Houston, TX; Department of Dermatology, University of Texas Medical
School, Houston, TX; and Wayne State University Medical School,
Detroit, MI.
Address reprint requests to: Harrison P. Nguyen, BA, 1 Baylor Plaza,
Houston, TX 77030; e-mail: Harrison.p.nguyen@gmail.com.

DOI 10.2310/7750.2013.13133
# 2013 Canadian Dermatology Association

are benign and asymptomatic, although erythema and

itchiness at the site of infection are reported in a subset of
patients.
Molluscum is transmitted through skin-to-skin contact
with the infected site, through contaminated fomites
such as bath towels and clothingand through vertical
transmission during labor. The virus can also be
autoinoculated, spreading from the initial site of infection
to other sites on the body.5 In 30% of patients, acute
eczema develops around the papules approximately a
month after onset of infection.6 Eczema is associated with
an increased risk of autoinoculation because patients are
more likely to scratch the eczematous region, thereby
spreading the viral particles to other sites of the body. The
acute eczema usually subsides spontaneously with the
eradication of the molluscum lesions. A further clinical
association between molluscum and eczema was elucidated
by an Australian study, which found that 62% of children
with molluscum contagiosum reported a history of eczema
and thus concluded that preexisting eczema likely predisposes children to the infection.5
Papules can appear on all cutaneous and mucocutaneous sites of the body, including the genitalia, as well as
the perianal, orbital, and oral mucosa. Molluscum of the
genitalia and perianal regions can be either autoinoculated
or sexually transmitted. Autoinoculation to the genitalia
can usually be distinguished by identifying lesions on

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multiple regions of the body; in contrast, most cases of

sexually transmitted molluscum are localized exclusively to
the genital area. In addition to infecting the genitalia,
molluscum can occasionally spread to the oral mucosa
potentially from the genitalia during oral sexas well as to
the conjunctiva and cornea.7,8 The latter scenario may
result in chronic conjunctivitis, keratoconjunctivitis, or
superficial punctate keratitis, which complicates treatment
of lesions in the orbital region.
Although data are limited, several studies have
estimated the worldwide prevalence of the infection to
be 5.0 to 7.5%.911 The prevalence is increased in
immunocompromised populations (5.018%) and has
been reported to be as high as 30% in patients with
advanced acquired immune deficiency syndrome
(AIDS).10
In healthy patients, cutaneous molluscum contagiosum
is a self-limiting disease that often spontaneously resolves
in 6 to 9 months, usually without scarring. Current
therapy for healthy individuals merely accelerates the
clearance process and can be associated with unwanted
side effects, such as scarring, erythema, and discomfort. As
a result, although permutations of therapeutic strategy
may be implemented based on each patients unique case,
many clinicians simply choose to employ benign neglect
for the treatment of molluscum. However, benign neglect
is usually effective only in healthy individuals, who are
eventually able to mount a successful cell-mediated
immune response and overcome the viruss pathomechanisms. Quality of life is a factor to consider when deciding
whether or not to treat a pediatric patient as he or she may
suffer chastisement from peers at school if the lesions are
visible. Not treating pediatric infections also carries the
risk of the disease spreading to classmates, and this
consideration may favor the option of treatment over
benign neglect.
Currently, there is no Food and Drug Administration
(FDA)-approved therapy for molluscum contagiosum.
There is not one widely accepted standard of care, which
is especially problematic for immunodeficient patients,
who often suffer from severe, persistent molluscum.
Molluscum infection in the immunodeficient population
can be steadfastly recalcitrant to conventional treatment
and can become physically and psychologically debilitating, with hundreds of lesions developing on the body.
Unfortunately, little is known about the efficacy of various
therapies for the immunodeficient population. A plethora
of case reportseach describing successful treatment of
various singular immunodeficient patientshave been
published, but to our knowledge, there is no readily
2

available resource for the compilation and comprehensive

consensus of these findings. Finally, although molluscum
infection on the genitalia is commonly observed clinicallyusually as a result of autoinoculation of conventional molluscum infectiongenital lesions can be
accompanied by additional issues and problems that the
clinician must consider when treating these cases. For
example, although conventional molluscum can be
managed with benign neglect, sexually transmitted molluscum is important to treat not only for the benefit of the
patient but also to prevent spread to sexual partners.
Taken together, molluscum presents differently based on
the patient population and necessitates specific treatments
for each of the myriad presentations. Here we review key
findings and insightful clinical observations that have been
published on the management of the gamut of molluscum
contagiosum infections.

Clinical Management
Molluscum in Immunodeficient Patients
In healthy individuals, molluscum contagiosum is often a
self-limiting infection that generally clears completely
within several months. On average, 11 to 20 papules
appear on the body during the course of infection but
spontaneously resolve within 2 months.4 However, in an
immunodeficient host, MCV can cause severe, persistent
infection with hundreds of lesions that tend to be
recalcitrant to treatment. Extensive infection is indicative
of an advanced immunodeficient state.
Treatments that lead to wound formation, such as
curettage and cryotherapy, can be effective in immunodeficient patients with mild infection. However, overall, such
strategies are not optimal in immunocompromised
patients for two chief reasons. First, open wounds elevate
the risk of additional cutaneous infection, which commonly include candidiasis, human papillomavirusassociated warts, and staphylococcal pyoderma.12 Second, in
severe cases, the infection may be so widespread on the
body that treating individual lesions may not be practical
without risking continual autoinoculation. Several therapies, most of which are immunomodulators, have been
described in the literature to be successful for treating
molluscum in immunodeficient patients. These treatments
include 5% imiquimod cream, interferon-a (IFN-a)
injections, and cidofovir.
The most well-described therapeutic agent, topical
imiquimod, is available on the market as 5%, 3.75%, and
2.5% creams. It is thought to activate both innate and

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adaptive immunity through Toll-like receptor 7 (TLR7),

which is involved in pathogen recognition and the release
of several immunostimulatory cytokines.1315 A study
published in 2000 found 5% imiquimod (applied three
times weekly for up to 16 weeks) to be effective in
completely eradicating lesions in four of four adults with
advanced but stable human immunodeficiency virus type 1
(HIV-1) disease.16 Interestingly, subjects with HIV-1 had a
better overall response to therapy than both their
immunocompetent counterparts and the healthy children
who participated in the study. Additionally, successful
resolution using imiquimod three times per week has been
reported in a woman with Sjogren syndrome, a renal
transplant patient with multiple giant molluscum, and
several other HIV-positive patients with severe molluscum.4,1719 Imiquimod therapy often results in nonspecific
inflammation and dermatitis, especially in skin folds or in
areas that have been traumatized due to scratching. Less
common side effects include headaches, back pain, muscle
aches, tiredness, flu-like symptoms, swollen lymph nodes,
diarrhea, and fungal infections.20
IFN-a is a glycoprotein cytokine that is endogenously
produced in response to viral infection and produces several
proteins that are involved in inhibiting viral replication. The
recombinant form was initially used in dermatology mostly
for the treatment of recalcitrant condyloma acuminata until
a study, published over a decade ago, described the successful
resolution of severe molluscum in 11 patients and 50%
reduction in 18 patients (of a total of 30 subjects) after
intralesional injection of 1 megaunit of IFN-a weekly for
4 weeks.21 Since then, several articles have reported its
efficacy in treating lesions in patients with other immunodeficiency disorders using various dose frequencies. After the
incomplete success of the initial report, the next study in
1999 employed subcutaneous injections and increased dose
frequency to 3 megaunits of IFN-a three times a week for 6
months and then, afterwards, weekly injections for 3
months.22 This treatment strategy successfully achieved
95% clearance of molluscum in two siblings suffering from
putative combined immunodeficiency. A 9-year-old with
hyperimmunoglobulin E syndrome also underwent the same
therapy schedule as the siblings. This resulted in complete
clearance of his recurring molluscum lesions, which were
previously unresponsive to phenol, trichloroacetic acid,
cryosurgery, and imiquimod therapy.23 Most recently,
pegylated IFN-a was shown to completely resolve disseminated giant molluscum after 16 months of treatment in a 31year-old woman with idiopathic CD4+ lymphocytopenia.24
However, the regimen could not be increased from 50 mg per
week subcutaneously because the patients total leukocyte

count dropped to as low as 2,900/mL. In patients with low

leukocyte levels, it may be prudent to conduct regular white
blood cell counts when administering IFN-a treatment so
that the regimen can be adjusted accordingly.
Cidofovir, a nucleotide analogue of deoxycytidine
monophosphate, has been popularly used to treat
cytomegalovirus (CMV) retinitis in AIDS patients.
Readily available in the intravenous form, cidofovir
prevents viral transcription and replication by inhibiting
viral DNA polymerase.25 Not surprisingly, cidofovir is also
effective at inhibiting viral replication in a number of other
DNA viruses, including MCV. This discovery was made
haphazardly by Meadows and colleagues when an HIVpositive man noticed dramatic clearing of his molluscum
after being treated with intravenous cidofovir for treatment-resistant CMV retinitis.26 The mans molluscum was
previously unresponsive to cantharidin, cryotherapy,
curettage, IFN-a, and several other first-line treatments.
In the same study, another HIV-positive patient also with
concurrent CMV retinitis and molluscum contagiosum on
the face was successfully treated with intravenous cidofovir
at a dosage of 5 mg/kg once a week for 2 weeks, followed
by 5 mg/kg once every 2 weeks. This regimen was slightly
higher than used for the first patient, whose lesions
responded to a dosage of 2 mg/kg once weekly for 2 weeks
and then a maintenance therapy of 2 mg/kg every 2 weeks.
However, systemic cidofovir is known to be nephrotoxic,
so topical cidofovir has been explored as a potential
therapeutic agent for immunodeficient patients but has
thus far yielded promising but inconclusive results. A third
HIV-positive patient in the Meadows and colleagues study
achieved successful resolution of recalcitrant molluscum
infection on his face using 3% cidofovir cream daily for 5
days a week. The lesions, which originally covered 95% of
his face, were completely cleared within 1 month without
any sequelae. Moderate inflammation appeared during the
second week of therapy but spontaneously resolved 2
weeks later. Similarly, complete resolution of a severe case
of molluscum on the face of another HIV patient was
recently achieved in one authors investigational center
after 2 months of topical cidofovir compounded into a 2%
ointment (unpublished report). Currently, the topical
form is not readily available on the market and must be
compounded as a 1 to 3% cream (Dermovan, Galderma
Laboratory, Fort Worth, TX).
Molluscum in Pediatric Patients
Viral infections, such as the human papillomavirus and
HIV, can be vertically transmitted from mother to infant if

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proper measures are not taken. Although only a handful of

congenital cases are reported in the literature, it is believed
that MCV can be transmissible during labor as well. Given
that MCV has an estimated incubation period of 14 days to
6 months, molluscum lesions may not be visible on the
infant at birth and thus could explain the dearth of cases
reported in the literature.27 This observation has led to the
hypothesis that most infantile patients presenting with
molluscum likely contracted the infection through vertical
transmission.27 A literature review yielded seven reported
cases of congenital molluscum. Interestingly, in nearly all
reported cases, molluscum lesions appeared in a halo-like
ring around the scalp, which is likely associated with the
increased cervical pressure placed on this region of the
scalp during labor and delivery.27 Additionally, several of
the infants also presented with molluscum lesions on other
sites of the body. One 2012 case report identified a linear
track of molluscum lesions in the coccygeal region with
additional lesions presenting on the back and upper arm in
a 1-year-old infant.28 It is possible to confirm the mode of
transmission through viral genotyping, but to date, no
studies have examined the genotype of congenital
molluscum lesions. As in the case of sexually transmitted
molluscum, the main therapy for congenital molluscum
lesions is direct destructive measures with curettage or
cryotherapy. Alternatively, the lesions have also been
successfully resolved with the topical agent 0.7% cantharidin.27 Although cantharidin is used by many physicians in
the United States as an off-label treatment for molluscum,
the compound is not currently approved by the FDA and
therefore is often acquired from Canada.29
Noncongenital molluscum infections in children are
responsible for myriad pediatrician and dermatologist visits
each year. A common treatment used for these infections is
topical cantharidin. Although topical cantharidin is often
used to treat pediatric molluscum infections, its potency
might not be as evident in this patient population as
originally believed. A double-blind randomized clinical trial
evaluated the treatment of 29 children ages 5 to 10 years
with topical cantharidin. The performance of cantharidin
was observed to be similar to that of the placebo. However,
the authors conceded that their definition of clearance
may have been stricter than similar trials, which may have
impacted the results.30 Regardless of this studys findings, a
survey of 95 clinicians indicated a 92% satisfaction rate with
cantharidins efficacy in treating molluscum, possibly
indicating a disparity between objective and subjective
satisfaction with the therapy.31
Additional therapies for pediatric molluscum include
topical imiquimod, curettage, cryotherapy, retinoids,
4

cimetidine, salicylic acid, duct tape, Candida antigen,

potassium hydroxide (KOH), and cidofovir.32 Hanna and
colleagues conducted a randomized controlled trial
comparing the efficacies of curettage, cantharidin, imiquimod, and a combination of salicylic acid and lactic acid.33
The study included 124 pediatric patients equally sorted
into four groups. For the curettage group, 80.6% required
only one visit, 16.1% required two visits, and 3.2%
required three visits for treatment of their molluscum.
Comparatively, the percentages were 36.7%, 43.3%, and
20.0% for cantharidin; 55.2%, 41.4%, and 3.4% for
imiquimod; and 53.6%, 46.4%, and 0% for salicylic and
glycolic acid. Thus, curettage was reported as the most
potent treatment, along with having the lowest incidence
of side effects.
Imiquimod 5% cream has received attention as a
pragmatic treatment option for pediatric molluscum
infection because the cream can be applied at home,
decreasing the burden of parental responsibility of followup visits. In a study comparing the effects of imiquimod
5% cream versus cryotherapy for molluscum contagiosum,
cryotherapy was performed with liquid nitrogen for two
10- to 20-second cycles on a group of 37 patients at an initial
visit and 1 week later if needed, whereas the other group of
37 patients received imiquimod cream five times weekly for
up to 16 weeks. Although the investigators observed a more
rapid clearance of the infection in the cryotherapy group at
6 weeks, there was no statistical difference between the two
groups after a 12-week period, with both groups demonstrating approximately 100% clearance. At a follow-up
conducted 6 months after the study, the imiquimod group
exhibited a superior cosmetic outcome, with only 2 patients
displaying residual hypopigmentation, versus 15 patients
with pigmentary changes and 8 patients with scarring or
atrophy in the cryotherapy group. There were no cases of
relapse in the imiquimod group, although there were 3
patients in the cryotherapy group whose infections
relapsed at 6 months.34 An additional study conducted
in India evaluated the safety and efficacy of imiquimod
5% cream versus 10% KOH solution, applied 3 days per
week, in patients between the ages of 1 and 40. The mean
lesion count decreased from 22.39 to 10.75 in the
imiquimod group (18 patients) and from 20.79 to 4.31
in the KOH group (19 patients) at the end of 12 weeks.
Complete clearance of the infection was observed in 8
(44%) of the imiquimod patients and 8 (42.1%) of the
KOH patients. The researchers concluded that both
topical methods were effective in treating molluscum,
although KOH had a faster onset of action but was also
associated with a greater incidence of side effects.35 A

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Turkish study examined the application of 10% KOH

aqueous solution in 40 pediatric patients with molluscum.
Parents were instructed to apply the solution twice a day
to all lesions and continue until the lesions showed signs
of inflammation or superficial ulceration. Complete
clearance was achieved in 37 (92.5%) patients after a
mean period of 4 weeks. Local side effects were
experienced by 12 children (32.4%), but it was concluded
that KOH was a safe, effective, and inexpensive treatment
for molluscum in children.36
A study published in 2011 indicated that immunotherapy in the form of intralesional Candida antigen injection
may serve as a promising treatment for pediatric
molluscum infections. The study participants were administered no more than 0.3 mL of Candida antigen
intralesionally at 4-week intervals until clearance of the
infection was achieved. The treatment effected complete
clearance in 55.2% of the 29 pediatric patients and partial
clearance in 37.9%, with a treatment total response of
93%. The only reported side effects were pain and
discomfort at the time of injection.37
A final potential oral therapy for pediatric molluscum
is the H2-receptor antagonist cimetidine. When administered to 13 children at a dose of 40 mg/kg/d, complete
clearance of the lesions was seen in 10 of the patients.38
Although these results seem promising, cimetidine may be
effective only in atopic patients.39
Molluscum in Adults
Molluscum infections are most common in children ages 1
to 10, but adult infections also occur.40 Sexually active
patients are more susceptible to molluscum infections in
specific anatomic regions, mainly the genital area.
Molluscum contagiosum commonly infects the genitalia
either through autoinoculation of conventional molluscum from other sites of the body or through sexual
transmission of the genital lesions on another individual.
Regardless of the infection source, genital infection must
be attentively managed.
A recently published 20-year longitudinal study
indicated that although the rates of other sexually
transmitted infections (STIs) in the authors community
hospital have remained relatively stable over the past two
decades, there has been a threefold increase in the number
of cases of molluscum infection in the genital and perianal
regions.41 A subsequent study found molluscum to be the
second most prevalent nonulcerative sSTI after genital
warts. This relative increase is thought to be a result of the
persistent and recurrent nature of viral infections.42 One

Dutch study reported that sexually transmitted molluscum

infections accounted for 1 to 3% of all reported cases of
STIs and estimated the worldwide prevalence of sexually
transmitted molluscum to be between 2 and 8% of the
total population. The disease is most prevalent in the 20to 30-year-old age group and affects men and women
equally. There is an increased incidence of disease in
heterosexual populations compared to homo- and bisexual
populations.4143 Additionally, there is an increased
prevalence of sexually transmitted molluscum in married
patients.
Sexually transmitted molluscum is diagnosed primarily
through an evaluation of patient history and physical
examination, noting the localization of the molluscum
lesions to the genital and perianal regions. Although single
lesions may occur, sexually transmitted molluscum lesions
are typically found in clusters of 30 papules or fewer in
otherwise healthy individuals.43 Molluscum can be identified by its characteristic central umbilication, but in cases
where the clinical picture is not clear, laboratory testing
may be used to confirm the diagnosis.42 Patients testing
positive for genital molluscum infection should be tested
for other concurrent STIs as a precautionary measure.43
Although the efficacy of therapeutic interventions continues to be debated in conventional, nonsexually
transmitted cases of molluscum, active treatment in
sexually transmitted cases is unequivocally indicated.41
This course of action is favored to reduce the risk of
further sexual transmission, to prevent additional autoinoculation, and to improve a patients quality of life.43 An
Indian study notes that evidence is accumulating that STIs,
including molluscum, augment HIV infectiousness and
promote its transmission.42 This further demonstrates the
need for prompt management of sexually transmitted
molluscum contagiosum.
The standard treatment for molluscum lesions is
generally the same as the treatment for the genital warts
caused by the human papillomavirus. Physical ablation of
the infected tissue via curettage, electrocautery, or
cryotherapy is considered to be first-line therapy in the
treatment of sexually transmitted molluscum.43 One study
reported clearance of infection in 92.3% of patients after
15 days of ablative treatment.41 However, as noted above,
in patients concurrently infected with molluscum contagiosum and HIV, destructive therapies may not be
effective. Instead, other treatment strategies should be
developed, particularly in cases of giant, recalcitrant, or
extensive molluscum infection that are often seen in
immunocompromised patients.44 Physicians may alternatively use chemical ablation such as trichloroacetic acid or

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podophyllin to destroy infected tissue. However, because

of the low efficacy and high toxicity of these treatments,
they are not commonly used.43
In addition to physician-administered physical and
chemical ablation, there are a number of treatment options
that may be self-administered by the patient. Podofilox,
which is the active ingredient in podophyllin, and retinoic
acid have been shown to have varying success in treating
cutaneous warts and may be effective in treating
molluscum lesions.43,45 The most common side effects
noted in these self-administered ablative treatments are
xerosis, burning, irritation, itching, inflammation, and
erosion.43 Self-administered topical treatments that modulate the local immune response have been used in the
treatment of genital molluscum lesions. In clinical trials,
treatment with 5% imiquimod 5 days a week for 4 to 16
weeks led to complete clearance in 80% of study patients
and a 50% reduction in molluscum lesions in the
remaining 20%, with very low recurrence rates at 32
weeks posttreatment.46 An additional double-blind study
found that three times daily application of 1% imiquimod
for 4 weeks resulted in a clearance rate of 86%.47 In our
clinic, we frequently use 3.75% imiquimod cream as well
as sinecatechin ointment to treat genital molluscum (data
forthcoming). The most common side effects of imiquimod treatment were erythema, erosion, and pruritus.43
As previously mentioned, molluscum can occasionally
spread to the oral mucosa. Although it is most commonly
observed in epidermal tissues, a review of the literature
found six reported cases of molluscum infections of the
oral cavity in immunocompetent individuals. These cases
presented as single or multiple papules with the characteristic central umbilication, although case reports note a
great deal of variance in the appearance of intraoral
molluscum lesions.4851 Intraoral molluscum papules have
been described as skin colored, yellowish white, and waxy.
In one case, a smooth nodule 2.5 cm in diameter initially
suspected to be squamous cell carcinoma was found to be
a molluscum lesion on histologic analysis.51 Intraoral
molluscum lesions are typically localized to the labial and
buccal muscosa as well as the hard palate. Mild erythema is
often observed surrounding the papule clusters.4851
Multiple studies have reported complete clearance of
molluscum lesions with minimal scarring within 2 weeks
of curettage or excisional biopsy.4851 In one of these
studies, no additional or recurring lesions were found
during a follow-up examination 2 years later.48
Ocular and periocular molluscum infections can occur
in pediatric, adult, and immunosuppressed patients.
Molluscum lesions in these regions can be difficult to
6

identify or are unusual in appearance. One retrospective

study of several histologically proven cases of molluscum
contagiosum found that molluscum was not diagnosed
during the initial visit in up to 40% of the cases.52 As in
most cases of molluscum infection, diagnosis of ocular or
periocular molluscum is made based on the presence of the
characteristic molluscum lesions in the eye and orbital
regions with or without additional lesions on the face or
body. Rarely, molluscum lesions may be found in the
conjunctiva or epibulbar region of the cornea. Chronic
conjunctivitis or keratoconjunctivitis secondary to molluscum infection has been associated with both ocular and
periocular molluscum lesions. In most cases, patients
present with chronic conjunctivitis as their primary
complaint, and a diagnosis of molluscum contagiosum is
made on physical examination.52,53 However, the conjunctivitis is believed to be secondary to molluscum
infection and is hypothesized to result from either a host
hypersensitivity reaction to MCV proteins or toxic damage
mediated by MCV.52 The most common treatment for
ocular and periocular molluscum infections is surgical
excision of the lesions, which has generally led to rapid and
dramatic resolution of the disease.5254 The concurrent
conjunctivitis has been frequently observed to resolve
simultaneously with the clearance of the molluscum
lesions, which provides further evidence that conjunctivitis
occurs as a secondary disease.52

Conclusion
There is no FDA-approved standard of care and no widely
accepted form of treatment for molluscum contagiosum.
Further research is needed for identifying and standardizing therapies that are effective and associated with limited
side effects. Additionally, future studies should investigate
outcome measures, such as transmission rates, recurrence,
and disease-related quality of life. A standardized outcome
measure for each treatment would likely facilitate comparative assessment. Molluscum contagiosum is an
uncomplicated, self-resolving infection for most healthy
patients, which explains why this disease has diminished in
attention and investigation. However, molluscum has
myriad clinical presentations based on the patient
population and/or anatomic location affected. If these
multifarious clinical scenarios are not managed properly
with case-specific treatment, there is the potential for
debilitating infection. This information should highlight
the urgency of finding effective therapeutic strategies for
molluscum contagiosum.

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Acknowledgment

<

Financial disclosure of authors and reviewers: None reported.

19.

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Rev 7.51n/W (Jan 20 2003)