Topical molluscum treatment
MolluDab, a topical solution of potassium hydroxide 5%, has been launched for the treatment of molluscum contagiosum. Applied directly, potassium hydroxide causes cells affected by the molluscum virus to dissolve, producing an inflammatory reaction in the affected skin, after which healing occurs.1
Potassium hydroxide 5% solution showed efficacy in a clinical study involving 21 children aged two to 13 years with multiple molluscum contagiosum lesions that had been present for four to eight months. The solution was applied twice daily to each lesion until an inflammatory reaction was visible in all lesions.2
Time to development of inflammation or superficial ulceration was three to six days, with complete resolution of symptoms observed after 14 to 35 days. No recurrences were seen during two to eight months of follow-up.2
In another open-label study, potassium hydroxide 5% solution was compared with tretinoin 0.05% cream in 50 children aged six months to 14 years with molluscum contagiosum. Both treatments were applied once daily at bedtime.3
After four weeks, patients responded well to both treatments, with the mean lesion count decreasing from 9.48 (+/-3.00 SD) to 1.67 (+/-0.58 SD) in the potassium hydroxide group (n = 23) and from 8.35 (+/-2.82 SD) to 2.00 (+/-1.00 SD) in the tretinoin group (n = 23).3
Crusting and oedema were more common with potassium hydroxide, while scaling and dryness were more common with tretinoin.3
New actinic keratosis option
Zyclara is a cream containing 3.75% imiquimod, for the topical treatment of non-hyperkeratotic and non-hypertrophic actinic keratosis of the face and scalp. It is indicated when other topical treatment options are contraindicated or less appropriate.
Imiquimod is an immune response modifier that has been shown to increase systemic levels of interferon alfa and other cytokines following topical application.4 It is already available as a 5% cream (Aldara) for use in the treatment of superficial basal cell carcinoma and external genital and perianal warts, as well as actinic keratosis.
The safety and efficacy of imiquimod were evaluated in two double-blind, placebo-controlled studies involving 319 patients with five to 20 typical visible or palpable AK lesions of more than 25cm2 on the face or scalp.5
Up to two sachets of imiquimod 3.75% cream or a matching vehicle cream were applied to the entire face or balding scalp once daily for two two-week treatment cycles separated by a two-week treatment-free period.5
Overall, 35.6% of patients treated with imiquimod 3.75% cream had complete clearance eight weeks post-treatment compared with 6.3% of those treated with placebo.5 The most commonly reported side-effects are application site reactions, including erythema, scabbing, exfoliation and dryness.4
1. MolluDab Package Insert, October 2012.
2. Jansen T et al. Akt Dermatol 2007; 33: 210-15.
3. Rajouria EA et al. Kathmandu Univ Med J 2011; 36: 291-4.
4. Zyclara Summary of Product Characteristics, August 2012.
5. Swanson N et al. J Am Acad Dermatol 2010; 62: 582-90.