Imiquimod therapy for molluscum contagiosum.
BACKGROUND
Molluscum contagiosum virus (MCV) is a large double-stranded DNA virus that is a member of the family Poxviridae, and which has a worldwide distribution. As with other poxviruses, MCV does not appear to develop latency but evades the immune system through the production of viral specific proteins.


OBJECTIVE
To evaluate the therapeutic efficacy of imiquimod 5% cream for MCV.


METHODS
Thirteen children >5 and <10 years old, 19 immune-competent adults and four adults with advanced, but stable HIV-1 disease with >10 MCV lesions were treated with topical 5% imiquimod cream three times weekly for up to 16 weeks.


RESULTS
Fourteen of 19 immune-competent adults, four of four adults with HIV-1 disease, and six of 13 children had resolution of their MCV lesions in <16 weeks of imiquimod therapy. Children tended to have more pruritus and inflammatory reactions with imiquimod, although most treated lesions appeared to respond. The development of new MCV lesions resulted in a lower overall resolution of the lesions in children. Imiquimod appeared to be the most efficacious in patients with HIV-1 disease and in the genital area in immune-competent adults.


CONCLUSIONS
Although topical imiquimod appears to have some efficacy in the therapy of MCV, in children the pruritus correlated relatively well with the development of new lesions. In adults, areas that would be expected to have better penetration appeared to respond more consistently. Although the HIV-1-positive patients had the largest clinical lesions at the onset of therapy, as a group they had the best overall response to therapy.
Liota
E
E
Department of Dermatology, National Naval Medical Center, Bethesda, Maryland 20089-5600, USA.
Smith
K J
KJ
Buckley
R
R
Menon
P
P
Skelton
H
H
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000367:Age Factors; D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D007369:Interferon Inducers / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008976:Molluscum Contagiosum / Q000188:drug therapy*; D009824:Ointments; D012008:Recurrence; D012737:Sex Factors; D013997:Time Factors
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D007369:Interferon Inducers; D009824:Ointments; D000077271:Imiquimod