title: Time to resolution and effect on quality of life of molluscum contagiosum in children in the UK: a prospective community cohort study.
abstract: BACKGROUND
  Molluscum contagiosum is one of the 50 most prevalent diseases worldwide, but scarce epidemiological data exist for childhood molluscum contagiosum. We aimed to describe the time to resolution, transmission to household child contacts, and effect on quality of life of molluscum contagiosum in children in the UK.
  
  
  METHODS
  Between Jan 1, and Oct 31, 2013, we recruited 306 children with molluscum contagiosum aged between 4 and 15 years in the UK either by referral by general practitioner or self-referral (with diagnosis made by parents by use of the validated Molluscum Contagiosum Diagnostic Tool for Parents [MCDTP]). All participants were asked to complete a questionnaire at recruitment about participant characteristics, transmission, and quality of life. We measured quality of life with the Children's Dermatology Life Quality Index (CDLQI). Participants were prospectively followed up every month to check on their recovery from molluscum contagiosum and transmission to other children in the same household, until the child's lesions were no longer visible.
  
  
  RESULTS
  The mean time to resolution was 13·3 months (SD 8·2). 80 (30%) of 269 cases had not resolved by 18 months; 36 (13%) had not resolved by 24 months. We recorded transmission to other children in the household in 102 (41%) of 250 cases. Molluscum contagiosum had a small effect on quality of life for most participants, although 33 (11%) of 301 participants had a very severe effect on quality of life (CDLQI score >13). A greater number of lesions was associated with a greater effect on quality of life (H=55·8, p<0·0001).
  
  
  CONCLUSIONS
  One in ten children with molluscum contagiosum is likely to have a substantial effect on their quality of life and therefore treatment should be considered for some children, especially those with many lesions or who have been identified as having a severe effect on quality of life. Patients with molluscum contagiosum and their parents need to be given accurate information about the expected natural history of the disorder. Our data provide the most reliable estimates of the expected time to resolution so far and can be used to help set realistic expectations.
  
  
  BACKGROUND
  Wales School of Primary Care Research (WSPCR) and Cardiff University.
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK. Electronic address: olsenjr@cardiff.ac.uk.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Olsen
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK.
authors.forename: John
authors.initials: J
authors.lastname: Gallacher
authors.affiliation: Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, Cardiff University and University Hospital of Wales, Cardiff, Wales, UK.
authors.forename: Andrew Y
authors.initials: AY
authors.lastname: Finlay
authors.affiliation: Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, Cardiff University and University Hospital of Wales, Cardiff, Wales, UK.
authors.forename: Vincent
authors.initials: V
authors.lastname: Piguet
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK.
authors.forename: Nick A
authors.initials: NA
authors.lastname: Francis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018562:Disease Transmission, Infectious; D005260:Female; D006801:Humans; D008297:Male; D008976:Molluscum Contagiosum / Q000453:epidemiology / Q000473:pathology* / Q000523:psychology* / Q000635:transmission; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology