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

Katz, Kenneth A.; Swetman, Glenda

doi:10.1542/peds.2013-0116

Cited by 39 publications

(36 citation statements)

References 4 publications

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“…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] …”

Section: Discussionunclassified

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

Frauches

Siqueira

Mata

2017

Rev Bras Med Fam Comunidade

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Molluscum Contagiosum treatment in children: a systematic literature review Objetivo: Molusco contagioso é uma infecção cutânea, causada pelo Molluscipox vírus. Diante da inexistência de um tratamento específico, esta pesquisa tem como objetivo verificar, segundo a literatura recente, os melhores métodos de tratamento em crianças imunocompetentes. Métodos: Revisão sistemática de literatura realizada no PubMed, bem como no Lilacs, Scielo, Medline e demais bases de dados abrangidas na Biblioteca Virtual em Saúde (BVS), com publicações de 2010 a 2016. Para evitar viés, foram utilizadas recomendações do PRISMA. Critérios do Oxford Centre for Evidence-Based Medicine e do sistema GRADE foram usados para classificação do nível de evidência dos estudos. Resultados: Curetagem, laser pulsado de contraste, crioterapia, exérese cirúrgica, KOH 2,5%, 5% e 10%, ácido tricloroacétrico, combinação de ácido lático e ácido salicílico, tretinoína 0,05% apresentaram boa proporção de cura, facilidade de realização e tempo de resolução. Os métodos de injeção intralesional do antígeno da Cândida e da vacina MMR, dieta balanceada, óleo de Malaleuca alternifólia e Ingenol Mebutate 0,05% mostraram-se promissores. Entretanto, cantaridina e imiquimod 5% creme não foram recomendados. Conclusão: As evidências obtidas não permitem indicar um método preferencial. A escolha do método de tratamento deve ser individualizada. Recomenda-se realizar mais pesquisas voltadas para cultura do vírus. Tratamiento del molusco contagioso en niños: una revisión sistemática de la literaturaObjective: Molluscum contagiosum is a skin infection caused by the Molluscipox virus. Given the absence of a specific treatment, this study aims to verify according to recent literature the best methods for molluscum contagiosum treatment in immunocompetent children. Methods: This study is a systematic review conducted in PubMed, as well as Lilacs, Scielo, Medline and other data bases from the Biblioteca Virtual em Saúde (BVS), including publications from 2010 to 2016. The bias is avoided by using PRISMA recommendations . Criteria of the Oxford Center for Evidence-Based Medicine and the GRADE system were used to rank the level of evidence of the studies. Results: Curettage, pulsed dye laser, cryotherapy, surgical abscission, KOH 2.5%, 5% and 10%, trichloroacetic acid, combination of lactic acid and salicylic acid and 0.05% tretinoin showed good performances regarding cure rate, ease of implementation and resolution time.Moreover, methods such intralesional injection of antigen Candida and the MMR vaccine, balanced diet, Malaleuca oil alternifolia and ingenol Mebutate 0.05% showed relevant results. However, the use of cantharidin and imiquimod 5% cream is not recommended. Conclusion: It is not possible to indicate the most eligible method based on the evidence found. Therefore, treatment should be individualized. Future researches about the virus culture are recommended. declaram não haver. AbstractParecer CEP:não se aplica. Conflito de interesses:declaram não haver. Procedê...

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Section: Discussionunclassified

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

Frauches

Siqueira

Mata

2017

Rev Bras Med Fam Comunidade

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“…The quantitative extensions of CA have generated significant advances in the statistical modeling of outcomes of interactional practices, for example, determining the influence of question design on patient responses (Heritage and Robinson 2006; Robinson and Heritage 2005, 2006; Heritage et al 2007), the significance of physicians’ opening remarks introducing vaccinations for parental adherence to the recommended vaccination regime (Opel et al 2013), and how the effectiveness of clinicians’ recommendations against antibiotics is shaped by other characteristics of communication during the medical visit (Mangione Smith et al 2006). These advances have led to the notion of a ‘conversation analytic intervention’ that captures the role of CA in intervention research (Robinson and Heritage 2014).…”

Section: Methodsmentioning

confidence: 99%

‘What Brings Him Here Today?’: Medical Problem Presentation Involving Children with Autism Spectrum Disorders and Typically Developing Children

Solomon

Heritage

Yin

et al. 2015

J Autism Dev Disord

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Conversation and discourse analyses were used to examine medical problem presentation in pediatric care. Healthcare visits involving children with ASD and typically developing children were analyzed. We examined how children’s communicative and epistemic capabilities and their opportunities to be socialized into a competent patient role are interactionally achieved. We found that medical problem presentation is designed to contain a ‘pre-visit’ account of the interactional and epistemic work that children and caregivers carry out at home to identify the child’s health problems; and that the intersubjective accessibility of children’s experiences that becomes disrupted by ASD presents a dilemma to all participants in the visit. The article examines interactional roots of unmet healthcare needs and foregone medical care of people with ASD.

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“…However, such studies with small numbers of patients were not sufficient for the FDA. In 2006, the FDA requested 3 studies in order to evaluate the real effectiveness of imiquimod in the treatment of molluscum contagiosum in pediatric patients (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) …”

Section: Editorialmentioning

confidence: 99%

“…2 Therefore, these RCTs remained in a "literature limbus"; not even mentioned in the Cochrane systematic review of treatment for MC, until 2013. 3 In 2015, this scenery changed when Kenneth A. Katz revealed these two unpublished RCTs 4 and this year two reviews didn't recommended imiquimod as a routine treatment for MC. 5,6 In Brazil there's no RCTs data regarding imiquimod use, but according to my personal observation the use of imiquimod for MC increased over the past three years in my country and (unfortunately) imiquimod is often mentioned in continuing medical education courses as a viable alternative for the treatment of MC in children.…”

mentioning

confidence: 99%

Molluscum Contagiosum: The Rise and Fall of Imiquimod

Oliveira¹

2016

JDC

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

Cited by 39 publications

References 4 publications

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

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

‘What Brings Him Here Today?’: Medical Problem Presentation Involving Children with Autism Spectrum Disorders and Typically Developing Children

Molluscum Contagiosum: The Rise and Fall of Imiquimod

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