Interventions for cutaneous molluscum contagiosum.
BACKGROUND
Molluscum contagiosum is a common skin infection, caused by a pox virus. The infection will usually resolve within months in people with a normal immune system. Many treatments have been used for molluscum contagiosum but a clear evidence base supporting them is lacking.This is an updated version of the original Cochrane Review published in Issue 2, 2006.


OBJECTIVE
To assess the effects of management strategies (including waiting for natural resolution) for cutaneous, non-genital molluscum contagiosum in otherwise healthy people.


METHODS
In June 2009 we updated our searches of the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 2, 2009), MEDLINE, EMBASE, and LILACS. We also searched ongoing trials registers, reference lists, and contacted pharmaceutical companies and experts in the field.


METHODS
We investigated randomised controlled trials (RCTs) for the treatment of molluscum contagiosum. We excluded trials on sexually transmitted molluscum contagiosum and in people with lowered immunity (including those with HIV infection).


METHODS
Two authors independently selected studies, assessed methodological quality, and extracted data from selected studies.


RESULTS
Eleven studies, with a total number of 495 participants, examined the effects of topical (9 studies), systemic, and homoeopathic interventions (1 study each). Limited evidence was found for the efficacy of sodium nitrite co-applied with salicylic acid compared to salicylic acid alone (risk ratio (RR) 3.50, 95% confidence interval (CI) 1.23 to 9.92); for Australian lemon myrtle oil compared to its vehicle, olive oil (RR 17.88, 95% CI 1.13 to 282.72); and for benzoyl peroxide cream compared to tretinoin (RR 2.20, 95% CI 1.01 to 4.79). No statistically significant differences were found for 10 other comparisons, most of which addressed 2 topical treatments.Study limitations included no blinding (four studies), many dropouts (three studies), and no intention-to-treat analysis; small study sizes may have led to important differences being missed. None of the evaluated treatment options were associated with serious adverse effects.


CONCLUSIONS
No single intervention has been shown to be convincingly effective in the treatment of molluscum contagiosum. The update identified six new studies, most of them reporting on interventions not included in the original version. However, the conclusions of the review did not change.
van der Wouden
Johannes C
JC
Department of General Practice, Erasmus MC, University Medical Center, PO Box 1738, Rotterdam, Zuid-Holland, Netherlands, 3000 DR.
van der Sande
Renske
R
van Suijlekom-Smit
Lisette Wa
LW
Berger
Marjolein
M
Butler
Christopher C
CC
Koning
Sander
S
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002927:Cimetidine / Q000627:therapeutic use; D006801:Humans; D006878:Hydroxides / Q000627:therapeutic use; D008976:Molluscum Contagiosum / Q000188:drug therapy / Q000628:therapy*; D008517:Phytotherapy / Q000379:methods; D017680:Potassium Compounds / Q000627:therapeutic use; D011206:Povidone-Iodine / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012075:Remission, Spontaneous; D020156:Salicylic Acid / Q000627:therapeutic use; D012977:Sodium Nitrite / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D006878:Hydroxides; D017680:Potassium Compounds; D002927:Cimetidine; D011206:Povidone-Iodine; D012977:Sodium Nitrite; D020156:Salicylic Acid