Beetle juice: a guide for the use of cantharidin in the treatment of molluscum contagiosum

Abstract

Molluscum contagiosum (MC) is an increasingly common cutaneous viral infection that primarily affects the pediatric population. MC lesions are benign, and most cases resolve within 6-9 months. Nonetheless, many patients and their parents seek active treatment of MC because of local pain, pruritus, embarrassment due to the lesions, or desire to reduce transmission to siblings. Individuals with atopic dermatitis are predisposed to severe and protracted MC, and immunocompromised patients may never clear the infection without treatment. Despite the availability of various therapies, no clear best treatment for MC has emerged. Cantharidin is a commonly used and effective therapy for MC that is generally well tolerated and has high rates of parental satisfaction. In this review, current literature regarding MC is summarized and particular focus is placed on the use of cantharidin for treating MC, including a review of the literature and detailed instructions for its use.

The infectious complications of atopic dermatitis

“…Treatments such as curettage, cryotherapy, salicylic acid, imiquimod, and cantharidin (beetle juice) are associated with either pain, the risk for scarring, or mixed results of efficacy. 62 However, a more recent randomized placebo-controlled trial has indicated efficacy in the use of cantharidin for the treatment of pediatric MC. 63 When evaluating pustule-vesicular rash in patients with AD with a military background or a history of close contact with a military personnel who had a recent vaccination, an index of suspicion for EV should be raised.…”

<p>Molluscum contagiosum: an update and review of new perspectives in etiology, diagnosis, and treatment</p>

“…Chemical methods destroy skin lesions through the inflammatory response they produce. Cantharidin is a topical agent, an inhibitor of phosphodiesterase, which produces an intraepidermal blister, followed by resolution of the lesion and healing without a scar in some cases 65. The efficacy of cantharidin in the treatment of MC is variable, with cure rates varying between 15.4% and 100% among the different studies 66,67.…”

Molluscum Contagiosum on the Lip

“…7,8 There is no evidence to favor any single therapy, but physical destruction of the lesions may be favored. 9 First-line destructive therapies include cryotherapy and cantharidin.…”

“…Its exact mechanism of eradication of the MC lesions is still unclear, but a number of researchers have found it to be a highly effective treatment. 7,8 Other therapies, such as imiquimod and cidofovir, are also reported. Imiquimod is a commonly used immune-enhancing therapy that has shown mixed results in terms of efficacy in treating MC.…”