Cutaneous Cryosurgery for Common Skin Conditions.

Cryosurgery is the application of freezing temperatures to achieve the destruction of tissue. Cutaneous cryosurgery has become a commonly performed outpatient procedure because of the combination of its safety, effectiveness, low cost, ease of use, lack of need for injectable anesthetic, and good cosmetic results. Cryosurgery may be performed in the outpatient setting using dipstick, spray, or cryoprobe techniques to treat a variety of benign, premalignant, and malignant skin lesions with high cure rates. Benign lesions such as common and plantar warts, anogenital condylomas, molluscum contagiosum, and seborrheic keratoses can be treated with cryotherapy. Basal and squamous cell carcinomas with low-risk features may be treated with cryosurgery. Contraindications to cryosurgery include neoplasms with indefinite margins or when pathology is desired, basal cell or squamous cell carcinomas with high-risk features, and prior adverse local reaction or hypersensitivity to cryosurgery. Potential adverse effects include bleeding, blistering, edema, paresthesia, and pain and less commonly include tendon rupture, scarring, alopecia, atrophy, and hypopigmentation.

Use of a disposable ear speculum: An alternative technique for molluscum contagiosum curettage.

Molluscum contagiosum is a common contagious disease in children characterized by small skin-colored umbilicated papules. Although spontaneous resolution is common, many parents and patients seek treatment. Multiple therapeutic modalities have been described. We present an easy, safe, caregiver-friendly, modified curettage technique using an ear speculum.

Giant molluscum contagiosum presenting as lid neoplasm in an immunocompetent child.

A three-year-old boy presented to our oculoplastic clinic with complaints of painless gradually increasing right upper lid mass for the last 6 months. On examination a firm mass measuring roughly 1x1 cm was present on the upper lid. The mass was non tender with fine superficial vessels running over it. A differential diagnosis of epidermoid cyst, vascular malformation, pilomatrixoma, and juvenile xanthogranuloma was considered. The patient underwent excisional biopsy of the mass. On gross examination the mass had a brain like appearance. Histopathological examination confirmed the diagnosis of molluscum contagiosum. It is rare for molluscum contagiosum to present as a solitary lid tumor. A brain like appearance of the excised mass can provide a clue towards the diagnosis.

Pulsed dye laser therapy for molluscum contagiosum: a systematic review.

BACKGROUND: Molluscum contagiosum (MC) is a benign contagious viral skin infection that typically resolves without treatment within months. For cases where treatment is recommended or requested, a number of options are available. Over the last 2 decades, a number of case reports and case series have described cases of MC lesions that were successfully treated with pulsed dye laser (PDL); however, a review of these studies has not been reported in the dermatologic literature. OBJECTIVES: To review the use of PDL for the treatment of MC. MATERIALS AND METHODS: A search of the National Library of Medicine's PubMed Database and the SCOPUS Database was performed to find articles that detailed the treatment of MC with PDL. RESULTS: Eight articles met criteria for inclusion in this review. These articles represented 161 patients with over 4200 MC lesions that were treated with PDL. Each article was reviewed and summarized in a table. LIMITATIONS: The main limitation of this review is the small number of published studies, which reflects the importance of this review of the dermatology literature. CONCLUSIONS: PDL offers a novel and effective treatment for MC. However, the articles reviewed herein suggest PDL is a safe, effective, quick and well-tolerated treatment for clearing MC lesions that does not cause scarring or permanent pigment change.

Beetle juice: a guide for the use of cantharidin in the treatment of molluscum contagiosum.

Molluscum contagiosum (MC) is an increasingly common cutaneous viral infection that primarily affects the pediatric population. MC lesions are benign, and most cases resolve within 6-9 months. Nonetheless, many patients and their parents seek active treatment of MC because of local pain, pruritus, embarrassment due to the lesions, or desire to reduce transmission to siblings. Individuals with atopic dermatitis are predisposed to severe and protracted MC, and immunocompromised patients may never clear the infection without treatment. Despite the availability of various therapies, no clear best treatment for MC has emerged. Cantharidin is a commonly used and effective therapy for MC that is generally well tolerated and has high rates of parental satisfaction. In this review, current literature regarding MC is summarized and particular focus is placed on the use of cantharidin for treating MC, including a review of the literature and detailed instructions for its use.

Giant molluscum contagiosum in an immunocompetent child.

Molluscum contagiosum is a skin disorder caused by DNA poxvirus and frequently seen in children. It is self-limited in immunocompetent hosts. It can present as numerous, treatment-resistant, atypical lesions in immunosuppressive patients and resistant to treatment. Atypical forms can rarely be seen in immunocompetent patients. A case of a two-year-old child with umbilicated papules on the eyelid is presented here. Laboratory investigations were unremarkable for systemic diseases, and surgical excision was successfully performed.

[Molluscum contagiosum--a common but poorly understood "childhood disease" and sexually transmitted illness]. / Mollusca contagiosa (Dellwarzen). Eine häufige, aber wenig bekannte "Kinderkrankheit" und sexuell übertragene Erkrankung.

Molluscum contagiosum is a viral disease of the skin characterized by discrete, multiple, flesh-colored papules. It is caused by a highly infectious, enveloped deoxyribonucleic acid virus, called molluscum contagiosum virus (MCV). Molluscum contagiosum is very common in children, sexually active adults and immunocompromised patients, especially those who are infected with the human immunodeficiency virus. MCV transmission usually takes place through direct skin-to-skin contact. Infections in childhood are often linked to swimming-pool attendance. Adults are infected usually through sexual contact. An intimate skin-to-skin contact is sufficient for transmission of the virus. In immunocompetent adults, the warts remain in the genital area and adjacent regions of the skin. In children and patients with immunocompromised conditions, however, various regions of the body are usually affected. Therapy of molluscum contagiosum should be undertaken in an individualized manner, a specific treatment does not exist. For the treatment, physical methods such as curettage and cryotherapy, topic acids (e. g., acetic acid) and alkalis (e. g., potassium hydroxide), some other topical agents such as cantharidin and imiquimod, as well as several systemic agents the pharmacological treatments is, however, sparse. Effective prevention is problematic due to the high infectivity of the virus. A vaccine is not available.

Cutaneous cryosurgery.

Cutaneous cryosurgery refers to localized application of freezing temperatures to achieve destruction of skin lesions. It can be used to treat a broad range of benign and premalignant skin conditions, and certain malignant skin conditions, with high cure rates. Cellular destruction is accomplished by delivery of the cryogen via dipstick, probe, or spray techniques. It is widely used in primary care because of its safety, effectiveness, low cost, ease of use, good cosmetic results, and lack of need for anesthesia. Cryosurgery is as effective as alternative therapies for most cases of molluscum contagiosum, dermatofibromas, keloids, and plantar or genital warts. It is a more effective cure for common warts than salicylic acid or observation. Cryosurgery is generally the treatment of choice for actinic keratosis. Contraindications to cryosurgery include cryofibrinogenemia, cryoglobulinemia, Raynaud disease, agammaglobulinemia, and multiple myeloma. Complications from cryosurgery include hypopigmentation and alopecia, and can be avoided by limiting freeze times to less than 30 seconds. Referral to a dermatologist should be considered in cases of diagnostic uncertainty or for treatment of skin cancer, which requires larger amounts of tissue destruction, resulting in higher complication rates.

Epidemiologic Differences and Management of Eyelid Lesions in the Pediatric Population.

PURPOSE: To report the relative incidence of excised pediatric eyelid lesions and describe the correlation between the clinical and pathology diagnosis. METHODS: This was a retrospective analysis of 137 consecutive pathology-confirmed eyelid lesions excised at a U.S. quaternary children's hospital system. Chalazion was excluded from this study. RESULTS: Benign non-cystic epithelial lesions comprised 48.2% of all excised lesions, followed by mesenchymal (14.6%) and cystic (10.2%) lesions. The most common lesions were molluscum contagiosum (21.9%) and verruca vulgaris (19.0%). Hispanic White race represented 62.0% of cases, followed by non-Hispanic White (23.3%) and Black (8.8%). There were no malignant lesions. A specific preoperative clinical diagnosis was attempted in 70.1% of cases. Of these, 60.4% had a matching histopathology. CONCLUSIONS: The authors report a higher proportion of molluscum contagiosum and verruca vulgaris when compared to the literature; these differences may suggest geographic variance, management preference, or a general increase in incidence. Correlation with pathology showed the clinical diagnosis of eyelid lesions can be challenging even for ophthalmologists. However, malignancy in pediatric eyelid lesions is rare and submission for histopathology may be safely omitted, except in cases with atypical features or suspicion for syndromic disease. The decision for surgery should be methodically approached and take into consideration the most likely diagnosis, natural history of the disease, sociopsychological impact, anesthesia risk, and resource burden. [J Pediatr Ophthalmol Strabismus. 2022;59(6):405-409.].

[The surface anesthesia in outpatient pediatric department].

The combination of even parts lidocaine and prilocaine in crème substance was used for surface anesthesia in 73 children, aged 1,5-16 years. Such surgical interventions as molluscum contagiosum eradication, laser wart resection and prepuce synechia dissection were performed. The described anesthetic was highly effective in all areas, but the nasolabial triangle. Resection of warts larger then 0,5 sm required either additional infiltrative anesthesia or step-wise resection. Local allergic reaction was registered in one case, no systemic reactions were noticed. Generally, the used method of surface anesthesia proved to be highly appropriate in pediatric practice.

Comparative study on the efficacy, safety, and acceptability of imiquimod 5% cream versus cryotherapy for molluscum contagiosum in children.

To compare the efficacy, safety and acceptability of imiquimod (IMQ) 5% cream with cryotherapy for the treatment of molluscum contagiosum (MC) in children. Prospective, randomized, comparative, observer blinded study. A total of 74 children, with MC were divided randomly to receive treatment with either IMQ 5% cream (group A) 5 days a week or cryotherapy (group B) once a week until clinical cure or up to a maximum of 16 weeks. All the patients were followed up weekly during active treatment. The patients were followed-up for 6 months after clinical cure to look for recurrence. In the IMQ group (group A), the overall complete cure rate was 91.8% (34 of 37), 22 of the 37 patients cleared by the end of 6 weeks and 12 more patients cleared by the end of 12 weeks, while the remaining three patients (8.1%) did not clear even after 16 weeks. Whereas, in the cryotherapy group, all 37 patients achieved complete cure, 26 of 37 (70.27%) patients cleared after 3 weeks, and the remaining 11 (29.72%) cleared by the end of 6 weeks. No statistically significant difference was found between the overall complete cure rate in both groups at the end of maximum treatment period (16 weeks). Pain, bullae formation, pigmentary changes, and superficial scarring were more significantly common in the cryotherapy group compared with the IMQ group. Imiqimod 5% cream seems to be slow acting but an effective agent for the treatment of MC in children. IMQ appears to be practically painless and more cosmetically accepted treatment when compared with cryotherapy, and may be the preferred treatment of MC in children especially with numerous small lesions. Cryotherapy has the advantage of being rapidly effective, and is less expensive than IMQ and may be the preferred treatment for large solitary or few lesions.

[Eyelid molluscum contagiosum: a case report]. / Molluscum contagiosum palpébral: à propos d'un cas.

Molluscums contagiosum (MC) are benign skin lesions caused by Molluscipoxvirus, primarily affecting children and young adults. They manly involve the skin and rarely the mucous membranes. Clinical diagnosis is easy, confirmed by histological examination of the lesion. However there is no consensus regarding therapy. Eyelid molluscum contagiosum is rare, posing a problem of differential diagnosis especially when it is isolated as well as a therapeutic problem given the proximity of the eyeball. We report the case of a 7-year old girl with isolated eyelid lesion. The patient underwent lesion excision. Anatomopathological examination showed molluscum contagiosum. This study aims to describe the clinical, therapeutic and evolutionary features of this rare localization of molluscum contagiosum.

Curettage treatment for molluscum contagiosum: a follow-up survey study.

BACKGROUND: Although curettage is commonly used to treat molluscum contagiosum, prospective studies on its effectiveness are lacking. OBJECTIVES: To evaluate prospectively the efficacy of curettage in the treatment of molluscum contagiosum and to identify the risk factors associated with treatment failure. METHODS: A systematic 2-month follow-up survey study was carried out on 73 patients treated by curettage for molluscum contagiosum. RESULTS: Treatment of molluscum contagiosum by curettage was associated with a high risk of treatment failure at week 4 (42/64, 66%) and at week 8 (25/55, 45%). Risk factors for treatment failure at week 4 and 8 were the number of lesions at day 0 (P < 0.001), the number of involved anatomical sites (P < 0.001) and concomitant atopic dermatitis (P = 0.038 and P < 0.001, at weeks 4 and 8, respectively). CONCLUSIONS: The main risk factor for treatment failure is lesion number, underlining the importance of the early detection of the lesions or, alternatively, emphasizing the need for therapeutic options other than curettage in patients with numerous lesions.

Treatment of molluscum contagiosum with a pulsed dye laser: Pilot study with 19 children.

BACKGROUND: Molluscum contagiosum is a common, self-limiting viral disease of childhood caused by a poxvirus. Often the children themselves and their parents desire treatment for cosmetic reasons or because of pruritus. Laser therapy offers another option to the traditional methods of treatment. METHODS: 19 children aged between 2 and 13 years (median:6) with molluscum contagiosum were treated in a prospective, non-randomized pilot study with the flashlamp pumped pulsed dye laser (wave length:585 nm, pulse duration 0,45 ms, spot size 7 mm, energy density 6-7 J/cm(2)). RESULTS: All patients tolerated the laser treatment well. In 84.3% one laser treatment led to total remission. In 10.5% a further laser session was necessary and one patient was treated three times to achieve total remission. CONCLUSIONS: Treatment of molluscum contagiosum with the flashlamp pulsed dye laser is a safe and efficient treatment modality.