What is the role of cantharidin in the treatment of molluscum contagiosum?

Updated: Aug 09, 2018
  • Author: Ashish C Bhatia, MD, FAAD, FACMS; Chief Editor: Dirk M Elston, MD  more...
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Cantharidin is a chemovesicant that is highly effective in treating molluscum contagiosum; however, this agent has lost favor with some physicians because of concerns regarding its safety. However, if cantharidin is used properly, it is very effective, safe, and well tolerated by children.

In a study by Silverberg et al in which 300 patients were treated with cantharidin, 90% of patients experienced complete clearing after an average of 2.1 visits. Blisters occurred at sites of application in 92% of patients. Temporary burning, pain, erythema, or pruritus was reported in 6-37% of patients. No major adverse effects were reported, and no patients experienced secondary bacterial infection. A total of 95% of parents reported that they would proceed with cantharidin therapy again. [45]

Cantharidin is not approved by the FDA for treatment of any condition; however, it has been used safely and effectively by dermatologists for many years. [46, 47] It is listed as acceptable therapy in the American Academy of Dermatology treatment guidelines for warts; however, because it has never been approved by the FDA for use in humans, it is no longer marketed as medical therapy in the United States. Cantharidin crystals and diluent can be purchased in the United States, and many dermatologists continue to use it. Cantharidin solution for the treatment of warts and molluscum is available in Canada and many other countries.

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