Molluscum Contagiosum: Review and Update on Clinical Presentation, Diagnosis, Risk, Prevention, and Treatment

Molluscum contagiosum (MC) is a self-limited cutaneous viral infection that most commonly affects children and immunocompromised populations. This review provides an update on the clinical manifestations, risk, diagnosis, treatment, and prevention of this frequently encountered infection. A recent Cochrane review concluded that there is insufficient evidence to establish the superiority of any specific treatment modality or to confirm that active intervention is superior to benign neglect (van der Wouden JC et al., Cochrane Database Syst Rev 5:CD004767, 2017). Interim pilot study data suggests that cantharidin outperforms placebo (Guzman AK et al., Int J Dermatol 57:1001–1006, 2018). Imiquimod is no longer recommended for treatment of MC (van der Wouden JC et al., Cochrane Database Syst Rev 5:CD004767, 2017; Papadopoulos EJ, https://www.fda.gov/files/drugs/published/N20-723S020-Imiquimod-Clinical-BPCA.pdf, 2006; Katz KA et al., Pediatr Dermatol 35:282–283, 2018). Optimal management strategies for MC remain unclear due to the multitude of proposed therapies, lack of high-quality evidence, and uncertain benefit of intervention for uncomplicated disease. Aside from watchful waiting, destructive therapies such as cantharidin and curettage are among the best studied methods and remain the treatment of choice for most patients.