Respiratory physician Lutz Beckert considers chronic obstructive pulmonary disease management, including the prevention of COPD, the importance of smoking cessation and pulmonary rehabilitation, and the lifesaving potential of addressing treatable traits. He also discusses the logic of inhaler therapy, moving from single therapy to dual and triple therapy when indicated, as well as other aspects of management
No effective interventions for molluscum contagiosum
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No effective interventions for molluscum contagiosum
How effective are different interventions for cutaneous, non-genital molluscum contagiosum in people without immune deficiency?
There was moderate-quality evidence that topical 5% imiquimod was probably no more effective than vehicle in achieving short, medium and long-term clinical cure. High-quality evidence showed topical 5% imiquimod was no better than placebo at improving molluscum contagiosum at up to 3 months after the start of treatment. High-quality evidence showed 5% imiquimod differed little or not at all in the number of side effects compared with vehicle. However, moderate-quality evidence suggested there were probably more application site reactions when using topical 5% imiquimod compared with vehicle. Other non-effective interventions included cryospray, 10% potassium hydroxide; 10% Australian lemon myrtle oil, olive oil, 10% benzoyl peroxide cream, 0.05% tretinoin; 5% salicylic acid, 5% sodium nitrite co-applied with 5% salicylic acid, iodine, tea tree oil, homeopathic calcarea carbonica ,10% povidone iodine solution and 50% salicylic acid plaster. Follow-up duration ranged from 3 to 28 weeks after randomisation.
Overall, study limitations included lack of blinding, many dropouts and no intention-to-treat analysis. Small study sizes resulted in broad confidence intervals and may have led to important differences being missed. Many common treatments, such as physical destruction, have not been adequately evaluated.
Molluscum contagiosum in healthy people is a self-limiting, relatively harmless viral skin infection. It mainly affects children and adolescents. It usually resolves within months in people without immune deficiency, but treatment may be preferred for social and cosmetic reasons or to avoid spreading the infection. A clear evidence base supporting the various treatments is lacking.
van der Wouden JC et al. Interventions for cutaneous molluscum contagiosum. Cochrane Reviews, 2017, Issue 5. Art. No.: CD004767.DOI: 10.1002/14651858. CD004767.pub4. This review contains 22 studies involving 1650 participants.