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Thursday, December 5, 2013
Skin Care and Diseases
My 15 month old son was just diagnosed with Mollescum. I do not know very much about the virus and want more information. Also, the dermatologist recommended Aldara cream. However, when reading the directions it says it is for children 9 years and older. It is also not FDA approved. I don`t want to use it until I get more information. Can you tell me more about Aldara and Mollescum? I have read a bit about Mollescum and it seems to be very contagious. Is is a problem to have my son in a nursery with other children if the area is covered or would you suggest completely staying away from others?
Mollescum contagiosa is a member of the pox family of viruses but does not immunologically cross-react with the more potent, virulent, and dangerous viruses such as monkey pox, small pox and cow pox. It is very common in children, particularly those that are in large care facilities. It is spread by exfoliated cells that contain the virus and children exchange cells in their play. They can be transmitted by inanimate objects such as towels, washcloths, and clothing.
It is called mollescum contagiosum because it is fairly contagious. The nursery individuals that take care of your child should just be careful to wash their hands or use gloves that are one-time-use so that they don't transmit from child to child. My only concern that I have about mollescum is problems with pustular formation and mild scarring or increased color at the site of an inflammatory response around the little papule.
Aldara (imiquimod) 5% cream is now widely used in the dermatologic community as an immune-enhancing material to make the body reject wart virus, molluscum, actinic keratoses, basal cell carcinoma, and even superficial in situ squamous cell carcinoma in some literature references. Your are correct that the FDA has not approved the drug for this purpose but that does not prevent its careful and useful application to other diseases. If you are interested in researching the literature, do a Medline search using mollescum and Aldara as the two reference words and I think you will be surprised to find the number of treatments that are purposed for mollescum, including Aldara. Your dermatologist is trying to prevent your child from being traumatized by destroying the lesions with liquid nitrogen or even surgical removal or the use of topical vesiculants such as cantheradine or even trichloroacetic acid, etc. I think you should discuss the pros and cons of using Aldara in your child based upon his experience and the age of the child.
I would be very careful about quarantine. I think the other children should be examined for mollescum since they probably gave it to your child and reinfection is common. Once again your board certified dermatologist can be of assistance in guiding you regarding the public health rules in your jurisdiction.
Charles L Heaton, MD
College of Medicine
University of Cincinnati