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No need to treat molluscum contagiosum

We often encounter the unmistakable molluscum contagiosum (MC) rash incidentally in our clinics, and parents may ask about treatment. It is caused by its own unique poxvirus and is highly contagious, but harmless. In the UK the advice is usually to leave well alone and await spontaneous resolution, but elsewhere treatment is often recommended. Researchers at Johns Hopkins in Baltimore, USA, reviewed 170 cases retrospectively (Basdag H, et al. Pediatric dermatology 2015. doi: 10.1111/pde.12504). Mean age at diagnosis was 5 years (range 1–15). 27% received some form of treatment, including various topical antivirals or locally destructive procedures such as cryotherapy. MC appeared to be more common in atopic children, particularly those with atopic dermatitis, present in 46%. This might be because of alterations in skin integrity or immunology, or just because atopic children are more likely to attend a skin clinic.

Complete resolution was seen within 12 months in 48%, and within 18 months in 72%. Treatment in any form made no difference, and nor did a history of atopy. We can now be more confident in our conviction that treatment, which can be unpleasant, painful and …

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