What is the role of caustic agents in the treatment of molluscum contagiosum?

Updated: Sep 21, 2020
  • Author: Ashish C Bhatia, MD, FAAD, FACMS; Chief Editor: Dirk M Elston, MD  more...
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Takematsu et al reported that disruption of the epidermal wall of Henderson-Paterson bodies induces acute inflammatory changes by activation of the alternative complement pathway on exposure to the tissue fluids; furthermore, the Henderson-Paterson bodies release proinflammatory cytokines and other neutrophil chemotactic factors upon decomposition. [42] This supports the observation that minor trauma to molluscum lesions frequently produces an inflammatory response and resolution of the lesion. The Henderson-Paterson bodies can be ruptured and a local inflammatory response created by various forms of physical trauma and caustic topical agents.

Various caustic agents have been shown to be effective in treating molluscum contagiosum. Tretinoin, salicylic acid, and potassium hydroxide [43, 44] may be used. Cantharidin, [36, 45] silver nitrate, [46] trichloroacetic acid, and phenol also are options. Children may tolerate therapy with these agents better than curettage or cryotherapy. None of these caustic agents has been approved by the FDA for treatment of molluscum contagiosum.

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