12/6/2016 IndianJournalofDermatology,VenereologyandLeprology(IJDVL):Topical20%KOHAneffectivetherapeuticmodalityformoluscumcontagiosum

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ORIGINALARTICLE
Year:2003|Volume:69|Issue:2|Page:175177

Topical20%KOHAneffectivetherapeuticmodalityformoluscumcontagiosumin
children
BBMahajan,APall,RRGupta
Dept.ofDermatology,Govt.MedicalCollege&Hospital,Faridhot151203,Punjab,India

CorrespondenceAddress:
BBMahajan
DermatologyDepartment,224MedicalCampus,Faridkot151203,Punjab
India

Abstract
SeniorLecturer,DermatologyDepartment,224MedicalCampusFaridkot151203(Punjab)India.Phone:01639
5213,Fax:0163951070Topically20%KOHaqueoussolutiononcedoilyatbedtimewasappliedin27children
havingmolluscumcontagiosumbytheirparents,tilllesionsshowedsignsofinflammationorsuperficialulceration.
24children(88.9%)completedthetrialandcompleteclearancewasachievedafterameanperiodof17days.No
recurrencewasobservedduringfollowupperiod.Thusinthisopentrialtopical20%KOHaqueoussolutionhas
provedtobeconvenient,easytoapplyathome,safeandinexpensivealternativetherapeuticmodalityforthe
treatmentofmolluscumcontogiosuminchildren.

Howtocitethisarticle:
MahajanBB,PallA,GuptaRR.Topical20%KOHAneffectivetherapeuticmodalityformoluscumcontagiosumin
children.IndianJDermatolVenereolLeprol200369:175177

HowtocitethisURL:
MahajanBB,PallA,GuptaRR.Topical20%KOHAneffectivetherapeuticmodalityformoluscumcontagiosuminchildren.
IndianJDermatolVenereolLeprol[serialonline]2003[cited2016Dec6]69:175177
Availablefrom:http://www.ijdvl.com/text.asp?2003/69/2/175/5912

FullText

Introduction

Molluscumcontagiosumisoneofthecommonestcutaneousviralinfectionsespeciallyseeninschoolgoingchildren.
Althoughthediseasemayresolvespontaneouslyyetpsychologicaleffectofwidespreadlesionsoftenwarrantsa
therapeuticalapproach.Currentlymanymodalitiesareavailablebutthesecanbeundertakenonlyinthe
hospital.Thisstudywasdonetoknowtheefficacyoftopical20%KOHaqueoussolutioninchildrenhaving
molluscumcontagiosumandtoknowthedurationoftreatmentanditssideeffectsfollowingtopicalapplication.

MaterialsandMethods

Inthisopenstudy,27childrenwithmolluscumcontagiosumweretreatedwithtopical20%KOHaqueoussolution.
Noothertherapeuticprocedureswithsystemicortopicalagentswereundertakenwiththistreatment.Parents
wereinstructedtoapply20%KOHaqueoussolutiononcedailyatbedtimewithacottonbudtoallthelesions.
Theywereadvisedtoapplyasmallamountofsolutiontoavoidspillagebeyondthelesion.Ifaccidentallyspillage
http://www.ijdvl.com/printarticle.asp?issn=03786323year=2003volume=69issue=2spage=175epage=177aulast=Mahajan 1/3
12/6/2016 IndianJournalofDermatology,VenereologyandLeprology(IJDVL):Topical20%KOHAneffectivetherapeuticmodalityformoluscumcontagiosum

occurred,theywereadvisedtowashtheskinwithcoldwaterimmediately.Thistreatmentwascontinuedtillthe
lesionsshowedsignsofinflammationorsuperficialulceration.Theassessmentoftherapeuticresponsewasclinically
seenatweeklyintervalsforfirstthreeweeksandthenmonthlyforthreemonths.

Results

Inthisopentrial,27childrenweretreatedwithtopical20%KOHaqueoussolutiononcedailyatbedtime.Theage
ofchildreninthistrialvariedfrom8monthsto14years(meanage5.8years).Outofthese27children15
(55.6%)weremalesand12(44.4%)werefemales.7children(25.9%)werehavingalesionsonsinglesiteofthe
bodywhereasin20children(74.1%),multiplesiteswereinvolved.24children(88.9%)completedthetrial.All
thesechildrenachievedcompleteclearanceofthelesionsafterameanperiodof17days.Thedevelopmentofin
flammationandulcerationtimevariedgreatlyaccordingtothesizeandlocationofthelesions.Norecurrenceswere
observedduringfollowupperiod.Mostofthechildrenreportedamildstingingsensationlastingfor1to2minutes
afterapplication.Ofthedropouts,2children(7.4%)didnotcomplyreportingseverestingingsensationfollowedby
ulcerationandthirdchildstoppedthetreatmentashedevelopedsecondarybacterialinfection.Attheendofthe
triallocalsideeffectswereobservedin8children(29.6%).Theseincludedsecondaryinfectionin2children(7.4%),
severestingingsensationin2children(7.4%)andhypopigmentationin4children(14.8%).Only8children
(29.6%)hadahistoryofprevioustreatmentwhereas19children(70.4%)hashadnotreatment.Numberof
lesionsinthesechildrenvariedfrom4to27(mean13).Timetakenforcompletedisappearanceoflesionsvaried
from13to22days(mean17days).

Discussion

MolluscumcontagiosumiscausedbyMCvirus,thelargesthumanvirusandsolememberofgenusmolluscipox.[1]
Tilldate,thereisnospecifictreatmentavailableformolluscumcontagiosum.Variouschemicalagentsviz.
podophyllin,tretinoin,cantharidin,trichloroaceticacid,silvernitrate,phenol,salicylicacidandtinctureiodinehave
beenusedwithvariableresults.[2],[3]Newermodalitiesintheformofelectriccautery,cryosurgeryandlaserare
alsoavailable.[4]Allthesetherapeuticapproacheshavetobeundertakeninthehospitalandtheyhavetobe
repeateddependingupontheirresponse.Sothesearchforanalternativetherapeuticmodalitythatcanbeusedat
homeespeciallyinchildrenisbeingrequired.Takingthisintoconsiderationwehaveundertakenanopentrialwith
20%KOHaqueoussolutiontobeappliedoncedailyatbedtimeinchildrenhavingmolluscumcontagiosum.

Potassiumhydroxideinvaryingconcentrationisroutinelyusedbydermatologiststoidentifyfungalelementsinskin
scrapings.KOHisknowntopenetratedeeplyanddestroytheskinbecauseitdissolveskeratin.Itcanalsocausean
irritantreactionintheskinvaryingwiththeconcentration,bodyregionandindividualsusceptibility.[5]

Ofthe27childrenwithmolluscumcontagiosum,24(88.9%)completedthetrialwithclearanceofallthelesions.
Inflammationusuallydevelopafterameantreatmentperiodof5to7days.Parentswereadvisedtostopthe
treatmentassoonasinflammationorsuperficialulcerationbecameevident.Superficialulcerationcouldnotbe
avoidedevenwithbriefcarefulapplicationbytheparents.Mostchildrenfeltatransitorystingingsensationfor1to
2minutesshortlyaftertheapplications.Severestingingsensationimpededfurthertreatmentonlyin2children.All
parentsreportedthatitwaseasytoapplythesolutionathomeandallstatedthattheyprefertotreattheirchildren
athomeinsteadofusingamoreaggressivemodalityoftreatmentsuchaselectriccautery,cryosurgeryandlaser.

Spontaneousclearanceofmolluscumlesionsduringthetrialcannotbeexcludedbutstillaplacebocontrolledtrial
willbenecessarytoestablishtheexacttherapeuticefficacyofKOHtreatment.Neverthelesstopical20%KOH
solutionprovedtobeaneffective,safe,inexpensiveandnoninvasivealternativetherapeuticmodalityinchildren.
SoevaluationofvaryingconcentrationsofKOHatvarioussitesonthebodytoavoidunnecessarysideeffectsshould
alsobeundertaken.

References
1 MyskowskyPL.Molluscumcontagiosum.ArchDermatol1997133:10391041.
2 OhkumaM.Molluscumcontagiosumtreatedwithiodinesolutionandsalicylicacidplaster.IntJDermatol
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199029:443445.
3 GottliebSL,MyskoskyPL.Molluscumcontgiosum.IntJDermatol199433:453461.
4 SterlingJG,KurtJB.Viralinfection.In:TextbookofDermatology,editedbyChampionRH,BurtonJL,Ebling
FJG6thEdition,BlackwellScienceLtd.,Oxford,1998:9951095.
5 FroshPJ.Cutaneousirritation.In:RycroftPUG,MenneT,FroshPJ,ed.TextbookofContactDermatitis,2nd
ed.Springer.Verlag,Berlin,1995.

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