Treatment of Molluscum Contagiosum with Potassium Hydroxide: A Clinical Approach in 35 Children

Abstract

Potassium hydroxide (KOH) is a strong alkali that has long been known to digest proteins, lipids, and most other epithelial debris of skin scrapings to identify fungal infections. To our knowledge, KOH has never been used for the treatment of molluscum contagiosum (MC). We evaluated 35 children with MC for the clinical effectiveness of treatment with topical 10% KOH aqueous solution. The solution was applied by the parents of affected children, twice daily, on each MC lesion. The therapy was continued until all lesions underwent inflammation and superficial ulceration. Thirty-two of 35 patients achieved complete clinical cure after a mean treatment period of 30 days. Three children discontinued treatment: two reported severe stinging of the lesions and refused further applications; the other, with giant MC lesions, developed a secondary infection with prolonged treatment. Therapy with KOH was found to be effective and safe in the treatment of MC in children.

Comparative Study of 5 % Potassium Hydroxide Solution Versus 0.05% Tretinoin Cream for Molluscum Contagiosum in Children

“…4,5 Potassium hydroxide (KOH) is known to penetrate deeply and destroy the skin because it dissolves keratin. 6 Five percentage of KOH solution has been prescribed for molluscum, to be applied at home and has added advantage of being relatively painless. All-trans-retinoic acid (tretinoin) is easily available as cream base thought to involve the induction of local irritation which damages the viral protein-lipid membrane.…”

Molusco contagioso em tatuagem

“…7 More recently we have demonstrated the efficacy and safety profile of the use of potassium hydroxide (KOH) 5 to 10% in aqueous solution, in the treatment of molluscum contagious in immunocompetent children. [8][9][10] The solution must be applied at home by the patient or parents through the use of a swab on each lesion. The applications should be repeated daily until there are signs of erythema or local edema.…”

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

“…In these studies, the adverse reactions to imiquimod cream are reactions at the site of application, including erythema, ulceration, edema and scaling. Romiti et al 4 suggested 10% KOH solution as a safe, effective and inexpensive, noninvasive treatment of MC. The only defect of KOH treatment was local side effects which included a stinging sensation around the site of application, and hyper-or hypopigmentation.…”

“…Imiquimod cream is an immune response modifier that functions via induction of IFN-α and TNF-α, and also stimulates cell-mediated immunity 3 . KOH, on the other hand, resolves MC by dissolving keratin and destroying the skin 4 .…”