Comparative Study on the Efficacy, Safety, and Acceptability of Imiquimod 5% Cream versus Cryotherapy for Molluscum Contagiosum in Children

Abstract

To compare the efficacy, safety and acceptability of imiquimod (IMQ) 5% cream with cryotherapy for the treatment of molluscum contagiosum (MC) in children. Prospective, randomized, comparative, observer blinded study. A total of 74 children, with MC were divided randomly to receive treatment with either IMQ 5% cream (group A) 5 days a week or cryotherapy (group B) once a week until clinical cure or up to a maximum of 16 weeks. All the patients were followed up weekly during active treatment. The patients were followed-up for 6 months after clinical cure to look for recurrence. In the IMQ group (group A), the overall complete cure rate was 91.8% (34 of 37), 22 of the 37 patients cleared by the end of 6 weeks and 12 more patients cleared by the end of 12 weeks, while the remaining three patients (8.1%) did not clear even after 16 weeks. Whereas, in the cryotherapy group, all 37 patients achieved complete cure, 26 of 37 (70.27%) patients cleared after 3 weeks, and the remaining 11 (29.72%) cleared by the end of 6 weeks. No statistically significant difference was found between the overall complete cure rate in both groups at the end of maximum treatment period (16 weeks). Pain, bullae formation, pigmentary changes, and superficial scarring were more significantly common in the cryotherapy group compared with the IMQ group. Imiqimod 5% cream seems to be slow acting but an effective agent for the treatment of MC in children. IMQ appears to be practically painless and more cosmetically accepted treatment when compared with cryotherapy, and may be the preferred treatment of MC in children especially with numerous small lesions. Cryotherapy has the advantage of being rapidly effective, and is less expensive than IMQ and may be the preferred treatment for large solitary or few lesions.

Imiquimod, Molluscum, and the Need for a Better “Best Pharmaceuticals for Children” Act

“…Moreover, RCTs of imiquimod for MC in children continue to be designed, conducted, and reported without reference to the 2 BPCA RCTs. 6 This is not the first time that publication of studies conducted under BPCA or similar programs has been found lacking. One study found that only 44% of such studies were published in an indexed, peer-reviewed journal.…”

Tratamento de Molusco Contagioso em crianças: uma revisão sistemática de literatura

“…18 No entanto, apesar da cirurgia dermatológica ser extremamente segura e com baixo risco de complicações, os procedimentos cirúrgicos estão sujeitos a infecções, hemorragias, hematomas ou alterações da pressão arterial. 34 O imiquimod 5% creme, alvo de grandes discussões e divergências literárias, 15,16,[19][20][21][22] …”

“…O estudo por Al-Mutairi et al 15 relatou proporção de cura de 100% com 1 sessão por semana até a cura ou em um máximo de 16 semanas. O tempo de resolução das lesões foi em média três a seis semanas, sendo a técnica mais barata que outros métodos, como o imiquimod.…”

A potash solution to combat molluscum contagiosum where potash is to be considered a buffering agent in an acidic solution, instead to be designed as the very remedy, in men and women.

“…(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) So an atopic dermatitis that is not properly treated, can lead to the insurgence of the virus of the molluscum contagiosum.Signs and symptoms of molluscum contagiosum include bumps on the skin that are raised, round and flesh coloured, small -typically under about 1/4 inch in diameter, they characteristically have a small indentation (umbilication) or dot at the top near the center. They become red and inflamed and itchy and therefore may be easily removed by simple scratching or rubbing, which can spread the virus to adjacent skin.…”