Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
Topical Cidofovir for Molluscum
Information Bulletin #12 August/September 2000
Molluscum contagiosum is a skin condition that can affect adults and children with HIV/AIDS. Molluscum lesions appear as pearly, flesh-colored, raised, firm bumps. These lesions can appear on the face, arms, legs and the skin between the genitals and anus. Molluscum contagiosum is caused by a virus, and some researchers think that 90#37; of adults may be infected. In general, the symptoms of bumps on the skin only occur when the immune system is suppressed. Molluscum contagiosum can be very difficult to treat. Since better HIV drugs have been available, there have been individual reports that molluscum can get better when T4-cell counts increase. However, HIV drugs may not always be able to treat molluscum. Doctors have now reported that a specially made topical (for use on the skin) form of a drug called cidofovir (trade name Vistide) may successfully treat molluscum in some cases. Cidofovir is an intravenous drug that is approved for the treatment of a viral infection called cytomegalovirus (CMV). The report is based on two children with AIDS that had severe cases of molluscum. The molluscum lesions were disfiguring and made it hard for the children to socialize. The doctors mixed cidofovir with Dermovan, a widely available preparation (doctors call it a "vehicle") that's designed for delivering drugs through the skin. The mixture was applied to the molluscum lesions once a day, 5 days a week, for 8 weeks. Five to 15 days after beginning the cidofovir treatment, both children showed redness and a painful wearing down of the lesions, although the surrounding skin wasn't affected. According to the doctors, after 2 months of treatment, all the lesions that were treated went away. After more than two years, neither child has had the lesions come back. The doctors say that the way they mixed cidofovir with Dermovan (a process often done by pharmacists called compounding) was key to the treatment's success. When they tried a different version of topical cidofovir, it didn't work. The full text of the study contains details of the cidofovir preparation. The study was published in the August 2000 issue of the Archives of Dermatology. The full cite is Arch Dermatol. 2000;136:983-985. The full text can be read free-of-charge on the Internet at: http://archderm.ama-assn.org/issues/current/rfull/dce0004.html
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Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
