Benjamin Barankin M.D., Department of Dermatology,
University of Alberta, Edmonton, Canada on Aug 9,
Good case and great pictures. I would try cantharone/cantharidin
applied for 20-30 minutes under tape occlusion, and then washed
off with soap & water. Works great in our peds cases. You
may need to retreat since her molluscum are so large.
Melvin Gorelick MD, Monterey, CA, USA on Aug
I have had good luck with application of cantharone to mollusca
in children and adults. It is normally painless both in application
and in process. I apply it with a wooden cotton swab stick just
to the very top of the lesions.
Anthony Benedetto MD, FACP Clinical Assistant Professor
Department of Dermatology, University of Pennsylvania
School of Medicine, Philadelphia, PA and Medical Director
Dermatologic SurgiCenter Philadelphia, PA, USA on Aug
Another attempt with liquid nitrogen cryotherapy should be
given. This time when the area has thawed and as the pain begins
to escalate, immediately apply LMX4 cream. Pain should remitt
within less than 5 seconds. Topical anesthetics work much faster
in the post thaw period of cryotherapy than they do in the pre
Rick Sontheimer MD, Professor and Vice-Chairman, Dept.
of Dermatology University of Oklahoma Health Sciences Center
Oklahama City,OK, USA on Aug 9, 2005
As immunosuppressed pts can have disseminated fungal infections
(eg, crypto) that at times can present clinically as atypical
molluscum lesions, I would first obtain a confirmatory biopsy.
Khaled El-hoshy M.D., Troy, Michigan, USA on
Aug 11, 2005
I would bx to R/O crypto. Cantharidin paint 1 hour & wash
off. Repeat as needed q 7-14 days. Check sexual partner[s].
Shahbaz Janjua MD, Lalamusa, Pakistan on August
It is really an interesting case of molluscum with underlying
hypogammaglobulinemia and neutopenia. Local application of the
tincture of iodine should resolve most of the lesions in two
weeks. Repeated IVIG may be tried to prevent the recurrence.
In my opinion immunocompromised persons are susceptible to get
both fungal and viral infections.
Gabriela Frias, MD, Mexico City, Mexico on
Aug 14, 2005
I treat many immunocompromised patients, after transplantation,
and I have learned to be cautious. Topical Microcyn with transfer
factor has been the best results in our cases.
Khalifa Shaquie MD, PhD, Professor of Dermatology,
College of Medicine, University of Baghdad, Baghdad, Iraq
on August 15, 2005
The usual therapy of molluscum is through puncturing the lesions
by sharpened orange stick immersed in 15% phenol.This could
be repeated every five days until cure,usually once is enough.The
mechanism of action is to disturb the internal enviroment of
molluscum.5% iodine could be used in a similar manner.However,sometimes
just puncturing might be enough.The other technique of therapy
is to puncture the lesions by heated hair diathermy needle.
Abbas N. Alshammari M.D., Doha, Qatar om Aug
I agree with Prof.Sontheimer to exclude the possibility of
deep fungal especially cryptococcus infection since both may
present similarly with the same patient criteria.