Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Parent’s or child’s desire for office-based treatment. +++ Absolute + • Molluscum in facial, genital, or perianal area. +++ Relative + • Previous cantharidin application with severe blistering. + • Cantharidin 0.9% in flexible collodion.• Blunt-ended wooden applicator. + • Pain.• Blistering.• Secondary infection.• Temporary hyperpigmentation or hypopigmentation. + • Inflamed lesions should not be treated because they are resolving spontaneously.• If inflamed lesions are treated, they may blister more severely than uninflamed lesions.• Excoriated lesions do not need treatment. The central molluscum body has likely been mechanically removed. + • Patient and parent education is crucial for a successful relationship with families of children with molluscum.• Although molluscum contagiosum is a self-resolving infection, parents may demand treatment.• If a physician defers treatment of a few molluscum and numerous lesions later develop, the parents may “blame” this often unpreventable spread on the physician.• Treatment does not prevent transmission or the development of new lesions.• An initial trial of treatment of a few lesions may be helpful in demonstrating the sequelae of therapy. + • The patient should be comfortable and hold still for this therapy because moving may cause cantharidin to be applied in unintended locations and blistering may result. + • Apply a small amount of cantharidin to the applicator and transfer this to the molluscum lesion (Figure 37–1). + • Minimize contact with surrounding normal skin.• Ensure complete drying before the patient moves or dresses.• Treat a maximum of 20–30 lesions per visit.• Have the child bathe 4–6 hours after application.• The treated areas can be washed with a soft washcloth and mild soap.• If child experiences blistering, discomfort, or burning within the first 4 hours, the areas should be gently washed sooner.• Scrubbing of treated areas is not necessary and should be discouraged. ++Figure 37–1.Graphic Jump LocationView Full Size||Download Slide (.ppt)Treating a molluscum lesion with cantharidin on applicator. + • The blister that occurs with cantharidin therapy may be painful.• Apply antibiotic ointment to the areas twice daily until the blisters resolve.• Acetaminophen or ibuprofen can be given for pain.• Scarring, hyperpigmentation or hypopigmentation, and secondary bacterial infection may occur. + • Follow-up is suggested in 2–4 weeks to treat new lesions. ++Silverberg NB, Sidbury R, Mancini AJ. Childhood molluscum contagiosum: experience with cantharidin therapy in 300 patients. J Am Acad Dermatol. 2000;43:503–507. [PubMed: 10954663] Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.