An Open, Randomized, Comparative Clinical and Histological Study of Imiquimod 5% Cream Versus 10% Potassium Hydroxide Solution in the Treatment of Molluscum Contagiosum

Abstract

Background: Although molluscum contagiosum (MC) resolves spontaneously, there are several reasons to treat this dermatological disorder. Objective: To evaluate the safety and efficacy of 5% imiquimod cream versus 10% potassium hydroxide (KOH) solution in treating MC, and to propose the mechanism of cure by observing the histological findings. Methods: Imiquimod or KOH were applied by the patient or a parent 3 days per week until all lesions cleared. The number of MC lesions was counted and side effects were evaluated at 5 points during the treatment (the initial visit, week 2, week 4, week 8, and week 12). Histological changes were compared between 2 patients of each group, before and after the 2 weeks of application. Results: In both group, the mean lesion counts decreased all through to week 12, and the reduction in number of lesions were statistically significant in both groups (p＜0.005). Over 40% of each group developed local side effects, and no systemic side effects were noted in either group. Before treatment, histological findings showed little or no dermal infiltrates. After treatment, specimens showed dense lymphocytic infiltrates, especially T cells, around the lesions which had resolved. Conclusion: Both 10% KOH solution and 5% imiquimod cream are effective and safe treatment of MC.

An open, comparative study of 10% potassium hydroxide solution versus salicylic and lactic acid combination in the treatment of molluscum contagiosum in children

“…The results of this study suggested that both treatments were equally effective (12,13). The concentration of KOH was correlated with side effects.…”

“…Therapy with KOH was found to be effective and safe in the treatment of MC in children (8)(9)(10)(11)(12)(13). The combination of salicylic acid and lactic acid (SAL + LAC) which demonstrates keratolytic effect is also an efficient alternative treatment in children with MC (14,15).…”

Comparison of 10% potassium hydroxide solution versus cryotherapy in the treatment of molluscum contagiosum: An open randomized clinical trial

“…The efficacy of KOH 10% with imiquimod 5% cream were compared and both agents were equally effective (1,8), but KOH had a faster onset of action (8).…”

“…Molluscum contagiosum (MC) is a self-limited condition but due to its unattractive nature and possibility for transmission, it is recommended that it be treated (1,2). The treatment options are based on destructive or immune modulating modalities (1).…”

Potassium hydroxide 5% for the treatment of molluscum contagiosum

“…Also, 5% potassium hydroxide has been compared with 0.05% tretinoin cream;13 and 10% potassium hydroxide with salicylic acid plus lactic acid;14 cryotherapy;15 and imiquimod;16 all the trials were open-label with small numbers of patients (26-50 participants). No one treatment showed a clear benefit.…”