van der Wouden J C, Menke J, Gajadin S, Koning S, Tasche M J A, van Suijlekom-Smit L W A, Berger M Y, Butler C C
University Medical Center Rotterdam, Department of General Practice, Erasmus MC, Room Ff304, PO Box 1738, Rotterdam, Netherlands, 3000 DR.
Cochrane Database Syst Rev. 2006 Apr 19(2):CD004767. doi: 10.1002/14651858.CD004767.pub2.
Molluscum contagiosum is a common skin infection, caused by a virus, which will usually resolve within months in people with a normal immune system. Many treatments have been promoted for molluscum contagiosum but a clear evidence base supporting them is lacking.
To assess the effects of management strategies (including waiting for natural resolution) for cutaneous, non-genital molluscum contagiosum in healthy people.
We searched the Skin Group Specialised Register (March 2004), the Cochrane Central Register of Controlled Trials (2004, Issue 2), MEDLINE (from 1966 to March 2004), EMBASE (from 1980 to March 2004) and LILACS (from 1982 to March 2004) databases. We also searched reference lists and contacted pharmaceutical companies and experts in the field.
Randomised controlled trials for treatment of molluscum contagiosum were investigated. Trials on sexually transmitted molluscum contagiosum and in people with lowered immunity (including those with HIV infection) were excluded.
Study selection and assessment of methodological quality were carried out by two independent authors. As similar comparisons between two interventions were not made in more than one study, statistical pooling was not performed.
Five studies, with a total number of 137 participants, examined the effects of topical (three studies), systemic and homoeopathic interventions (one study each). Limited evidence was found for sodium nitrite co-applied with salicylic acid compared to salicylic acid alone (risk ratio (RR) 3.50, 95% confidence interval (CI) 1.23 to 9.92). No statistically significant differences were found for topical povidone iodine plus salicylic acid compared to povidone iodine alone (RR of cure 1.67, 95% CI 0.81 to 3.41) or compared to salicylic acid alone. Also no statistically significant differences were found for potassium hydroxide compared to placebo; systemic treatment with cimetidine versus placebo or systemic treatment with calcarea carbonica, a homoeopathic drug, versus placebo (RR 5.57, 95% CI 0.93 to 33.54). Study limitations included no blinding (two studies), many dropouts (three studies) and no intention-to-treat analysis (two studies); small study sizes may have led to important differences being missed. None of the evaluated treatment options were associated with serious adverse effects.
AUTHORS' CONCLUSIONS: No single intervention has been shown to be convincingly effective in treating molluscum contagiosum.
传染性软疣是一种常见的皮肤感染，由病毒引起，免疫系统正常的人通常会在数月内自行痊愈。目前已有多种针对传染性软疣的治疗方法，但缺乏明确的证据支持。
评估健康人群中皮肤非生殖器传染性软疣的管理策略（包括等待自然痊愈）的效果。
我们检索了皮肤组专业注册库（2004年3月）、Cochrane对照试验中心注册库（2004年第2期）、MEDLINE（1966年至2004年3月）、EMBASE（1980年至2004年3月）和LILACS（1982年至2004年3月）数据库。我们还检索了参考文献列表，并联系了制药公司和该领域的专家。
调查了治疗传染性软疣的随机对照试验。排除了关于性传播传染性软疣和免疫力低下人群（包括艾滋病毒感染者）的试验。
由两名独立作者进行研究选择和方法学质量评估。由于一项以上研究未对两种干预措施进行类似比较，因此未进行统计合并。
五项研究共137名参与者，考察了局部治疗（三项研究）、全身治疗和顺势疗法干预（各一项研究）的效果。与单独使用水杨酸相比，亚硝酸钠与水杨酸联合使用的证据有限（风险比（RR）3.50，95%置信区间（CI）1.23至9.92）。与单独使用聚维酮碘相比，局部使用聚维酮碘加水杨酸或与单独使用水杨酸相比，未发现统计学上的显著差异（治愈RR为1.67，95%CI为0.81至3.41）。与安慰剂相比，氢氧化钾也未发现统计学上的显著差异；西咪替丁与安慰剂的全身治疗或顺势疗法药物碳酸钙与安慰剂的全身治疗（RR 5.57，95%CI 0.93至33.54）。研究局限性包括未设盲（两项研究）、许多失访（三项研究）和未进行意向性分析（两项研究）；样本量小可能导致遗漏重要差异。所有评估的治疗方案均未出现严重不良反应。
尚无单一干预措施被证明对治疗传染性软疣有令人信服的效果。
