Study of Topical Potassium Hydroxide versus Candida Antigen Immunotherapy for Molluscum Contagiosum Management

Background: Molluscum Contagiosum (MC) has no FDA-approved treatments as of yet. Although many other treatments have been suggested, the majority of the efficacy evidence comes from modest case studies.
Objectives: The aim of the current work was to evaluate the safety as well as efficacy of intralesional candida Ag immunotherapy versus topical KOH (10 %) in the treatment of MC.
Patients and methods: A total of 40 patients (21females and 19 males) with multiple lesions of MC. They were divided into two equal groups at random; group 1 treated by candida antigen at 2 weeks intervals with a maximum of five injections or clinical cure. Group 2 subjected to topical 10% KOH twice daily for ten weeks.
Results: Complete clinical response was attained in 80% of MC patients who treated with candida antigen for 10 weeks versus 85% of patients who treated with topical KOH for 10 weeks, while 20 % of patients showed no response in group 1 versus 5% in group 2 after the end of therapy. without recurrence after 3 months in all patients demonstrating complete reaction. In group 1, most patients tolerated the side effects, which in 5% of cases manifested as erythema and hyperpigmentation. While in group 2, hypopigmentation (15%), hyperpigmentation (10%), pruritus (10%) during treatment were reported. There was significant reported burning sensation among 25% of patients treated with topical potassium hydroxide (P = 0.047).
Conclusion: It could be concluded that both topically applied KOH10% and intralesional candida are dependable, less expensive treatments for non-genital MC.