van der Wouden Johannes C, van der Sande Renske, van Suijlekom-Smit Lisette Wa, Berger Marjolein, Butler Christopher C, Koning Sander
Department of General Practice, Erasmus MC, University Medical Center, PO Box 1738, Rotterdam, Zuid-Holland, Netherlands, 3000 DR.
Cochrane Database Syst Rev. 2009 Oct 7(4):CD004767. doi: 10.1002/14651858.CD004767.pub3.
Molluscum contagiosum is a common skin infection, caused by a pox virus. The infection will usually resolve within months in people with a normal immune system. Many treatments have been used for molluscum contagiosum but a clear evidence base supporting them is lacking.This is an updated version of the original Cochrane Review published in Issue 2, 2006.
To assess the effects of management strategies (including waiting for natural resolution) for cutaneous, non-genital molluscum contagiosum in otherwise healthy people.
In June 2009 we updated our searches of the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 2, 2009), MEDLINE, EMBASE, and LILACS. We also searched ongoing trials registers, reference lists, and contacted pharmaceutical companies and experts in the field.
We investigated randomised controlled trials (RCTs) for the treatment of molluscum contagiosum. We excluded trials on sexually transmitted molluscum contagiosum and in people with lowered immunity (including those with HIV infection).
Two authors independently selected studies, assessed methodological quality, and extracted data from selected studies.
Eleven studies, with a total number of 495 participants, examined the effects of topical (9 studies), systemic, and homoeopathic interventions (1 study each). Limited evidence was found for the efficacy of 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); for Australian lemon myrtle oil compared to its vehicle, olive oil (RR 17.88, 95% CI 1.13 to 282.72); and for benzoyl peroxide cream compared to tretinoin (RR 2.20, 95% CI 1.01 to 4.79). No statistically significant differences were found for 10 other comparisons, most of which addressed 2 topical treatments.Study limitations included no blinding (four studies), many dropouts (three studies), and no intention-to-treat analysis; 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 the treatment of molluscum contagiosum. The update identified six new studies, most of them reporting on interventions not included in the original version. However, the conclusions of the review did not change.
传染性软疣是一种常见的皮肤感染，由痘病毒引起。免疫系统正常的人感染通常会在数月内自行痊愈。许多治疗方法已用于传染性软疣，但缺乏支持这些方法的确切证据基础。这是2006年第2期发表的原始Cochrane系统评价的更新版本。
评估在其他方面健康的人群中，针对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。
2009年6月，我们更新了对Cochrane皮肤小组专业注册库、Cochrane图书馆（2009年第2期）中的Cochrane对照试验中心注册库（CENTRAL）、MEDLINE、EMBASE和LILACS的检索。我们还检索了正在进行的试验注册库、参考文献列表，并联系了制药公司和该领域的专家。
我们调查了治疗传染性软疣的随机对照试验（RCT）。我们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。
两位作者独立选择研究、评估方法学质量，并从选定的研究中提取数据。
11项研究，共495名参与者，考察了局部治疗（9项研究）、全身治疗和顺势疗法干预（各1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疗效有有限证据支持（风险比（RR）3.50，95%置信区间（CI）1.23至9.92）；与载体橄榄油相比，澳大利亚柠檬桃金娘油的疗效有有限证据支持（RR 17.88，95%CI 1.13至282.72）；与维甲酸相比，过氧化苯甲酰乳膏的疗效有有限证据支持（RR 2.20，95%CI 1.01至4.79）。其他10项比较未发现统计学上的显著差异，其中大多数涉及两种局部治疗。研究局限性包括未设盲（4项研究）、许多失访（3项研究）以及未进行意向性分析；样本量小可能导致遗漏重要差异。所评估的治疗方法均未显示与严重不良反应相关。
尚无单一干预措施被证明对传染性软疣的治疗有令人信服的效果。本次更新识别出6项新研究，其中大多数报告的干预措施未包含在原始版本中。然而，系统评价的结论并未改变。
