Pulsed Dye Laser Therapy for Molluscum Contagiosum: A Systematic Review

November 2014 | Volume 13 | Issue 11 | Original Article | 1349 | Copyright © November 2014


Robert Denison Griffith MD,a Mohammad-Ali Yazdani Abyaneh BS, Leyre Falto-Aizpurua MD, and Keyvan Nouri MD

aUniversity of Miami Miller School of Medicine, Department of Dermatology and Cutaneous Surgery, Miami, FL

Abstract
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.

J Drugs Dermatol. 2014;13(11):1349-1352.

INTRODUCTION

Molluscum contagiosum (MC) is a benign contagious viral skin infection that causes smooth flesh-colored pearly umbilicated papules.1,2 A member of the Poxviridae family, the MC virus is transmitted by direct skin-to-skin contact, fomites or via autoinoculation, and is common among school-age children, sexually active young adults and AIDS patients.1,3,4 The skin lesions can appear anywhere on the body, but they typically do not cause any discomfort and resolve without treatment in 6-9 months. Therapeutic minimalism is the usual approach to management.3,5,6 However, there are cases of MC where treatment is requested by the patient or recommended by the physician.5
A number of treatment options are available for MC, but no therapy is universally effective. The most popular therapies can be grouped into three broad categories—topical or intralesional therapy, physical destruction, and systemic treatment.5 The topical or intralesional therapies for MC include: tretinoin, podophyllotoxin, cantharadin, and imiquimod.5,7 These treatments have varying degrees of success and must be used for a long period of time.5 Methods of physical destruction include: curettage, cryotherapy, manual extraction, electrodessication, and carbon dioxide (CO2) laser.5,8All of these procedures are painful, time-consuming and can cause scarring.5,9 Furthermore, curettage and manual extraction cause bleeding, making them undesirable treatment options for AIDS patients. Systemic therapy for MC includes oral cimetidine and cidofovir. Both medications have undesirable systemic side effects and must be taken on a daily basis for weeks. In addition, there have been reports of unsuccessful clearance of MC with these medications.10
In contrast to the aforementioned treatments, the pulsed dye laser (PDL) has been reported to be a safe, well tolerated, quick, and highly effective treatment for MC without any apparent permanent adverse effects. Reports in the literature pertaining to the use of PDL to treat MC, however, are limited to case reports and a few large case series. To our knowledge,
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