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

Abstract

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...

Molluscum Contagiosum in a Child With Atopy

“…The most affected age groups are from 1 to 14 years old, especially for the ease of transmission, apart from sexually active adults and immunocompromised people. A presentation before 1 year is rare, probably due to maternal immunization (FRAUCHES, 2017).…”

“…Transmission occurs for as long as the lesions are present (MINISTÉRIO, 2002) and occurs through fomites, skin contact or autoinoculation, or incubation time varies from 14 days to 6 months, and recurrence is very common (FRAUCHES, 2017).…”

“…This doença is expressed by single or multiple papules (GASPAR, 2012), cor da pele, between three and five millimeters in diameter, being able to reach 3 centimeters, appearing as a giant mollusk. Its striking characteristic is a central umbilication (depression) whereby a white-stained substance full of viruses can extravasate (FRAUCHES, 2017). The papules can also be shiny, cor rosy, smooth and located mainly in the armpits, lateral face of the trunk, genital regions, perinanal and face (MINISTÉRIO, 2002).…”

“…The diagnosis is predominantly clinical, through the identification of umbilicated lesions, but if the lesions are atypical, histopathological studies, microscopy and gram staining can be used (FRAUCHES, 2017).…”

“…sites, scars and atrophy. It is widely used due to its fast resolution and relatively low cost (FRAUCHES, 2017).…”