Hanna Dominique, Hatami Afshin, Powell Julie, Marcoux Danielle, Maari Catherine, Savard Pascal, Thibeault Huguette, McCuaig Catherine
CHU Sherbrooke, University of Montreal, Montreal, Quebec, Canada.
Pediatr Dermatol. 2006 Nov-Dec;23(6):574-9. doi: 10.1111/j.1525-1470.2006.00313.x.
Molluscum contagiosum is a common viral disease of childhood presenting as small, firm, dome-shaped umbilicated papules. Although benign and generally self-limited, this condition is contagious and can lead to complications such as inflammation, pruritus, dermatitis, bacterial superinfection, and scars. No consensus has been established concerning the management of this condition. We conducted a prospective randomized study comparing four common treatments for molluscum contagiosum in 124 children aged 1 to 18 years. One group was treated with curettage, a second with cantharidin, a third with a combination of salicylic acid and lactic acid, and a fourth with imiquimod. Patients needing, respectively, one, two, or three visits for treatment of their mollusca were: 80.6%, 16.1%, and 3.2% for curettage, 36.7%, 43.3%, and 20.0% for cantharidin, 53.6%, 46.4%, and 0% for salicylic acid and glycolic acid, and 55.2%, 41.4%, and 3.4% for imiquimod. The rate of side effects was 4.7% for group 1, 18.6% for group 2, 53.5% for group 3, and 23.3% for group 4. Curettage was found to be the most efficacious treatment and had the lowest rate of side effects. It must be performed with adequate anesthesia and is a time-consuming procedure. Cantharidin is a useful bloodless alternative particularly in the office setting, but has moderate complications due to blisters and necessitated more visits in our experience. The topical keratolytic used was too irritating for children. Topical imiquimod holds promise but the optimum treatment schedule has yet to be determined. Finally, we believe that the ideal treatment for mollusca depends on the individual patient preference, fear, and financial status, distance from the office, and whether they have dermatitis or blood-borne infections.
传染性软疣是一种常见的儿童病毒性疾病，表现为小而硬的圆顶状脐形丘疹。尽管这种疾病是良性的，通常具有自限性，但具有传染性，可能导致炎症、瘙痒、皮炎、细菌感染和疤痕等并发症。关于这种疾病的治疗尚未达成共识。我们进行了一项前瞻性随机研究，比较了124名1至18岁儿童传染性软疣的四种常见治疗方法。一组采用刮除术治疗，第二组采用斑蝥素治疗，第三组采用水杨酸和乳酸联合治疗，第四组采用咪喹莫特治疗。治疗传染性软疣分别需要就诊一次、两次或三次的患者比例为：刮除术组分别为80.6%、16.1%和3.2%；斑蝥素组分别为36.7%、43.3%和20.0%；水杨酸和乙醇酸组分别为53.6%、46.4%和0%；咪喹莫特组分别为55.2%、41.4%和3.4%。第一组的副作用发生率为4.7%，第二组为18.6%，第三组为53.5%，第四组为23.3%。结果发现刮除术是最有效的治疗方法，且副作用发生率最低。必须在充分麻醉下进行，且是一个耗时的过程。斑蝥素是一种有用的无血替代方法，特别是在门诊环境中，但根据我们的经验，由于水泡会有中度并发症，且需要更多次就诊。所使用的局部角质溶解剂对儿童刺激性太大。局部用咪喹莫特很有前景，但最佳治疗方案尚未确定。最后，我们认为，传染性软疣的理想治疗方法取决于个体患者的偏好、恐惧程度、经济状况、与诊所的距离以及是否患有皮炎或血源性感染。
