616 - Potassium Hydroxide for the Treatment of Pediatric Molluscum Contagiosum: A Systematic Review and Meta-Analysis

Letícia Rocha Campos, Universy of Ribeirao Preto (UNAERP), Ribeirão Preto, Sao Paulo, Brazil; Beatriz P.. Costa Bomfim, University of Pernambuco, Recife, Pernambuco, Brazil; Emma Finnegan, Trinity College Dublin, Dublin, Dublin, Ireland; Julia V. Vasconcelos, Universidade Federal do Ceará, Fortaleza, Ceara, Brazil; Davi Santos Lima, Franciscana University, Santa Maria, Rio Grande do Sul, Brazil; Luiza Thomopoulos Mariante, Faculdade Ciências Medicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Laura Carbonera Finn, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil; Thais Iwashita Lages, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto – Universidade de São Paulo, Ribeirao Preto, Sao Paulo, Brazil; Gisella Chiara Carpi, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil

Background: Molluscum contagiosum (MC) is a contagious, benign, and self-limited viral skin infection, primarily affecting the pediatric population and often associated with atopic dermatitis. While spontaneous resolution can take months to years, the traditional watchful waiting approach may increase the risk of infection spread and cause notable physical and psychological distress. Potassium hydroxide (KOH) has been considered a promising treatment option for viral skin infections, and therefore MC.

Objective: We aimed to assess the efficacy of 10% KOH versus placebo for the treatment of molluscum contagiosum.

Design/Methods: We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) comparing the use of 10% potassium hydroxide versus placebo in the treatment of molluscum contagiosum in children. Statistical analysis was conducted using Review Manager Version 7.2.0.

Results: We analyzed 141 patients from 3 randomized clinical trials. The mean follow-up in patients was 60 days (SD=30). The mean age of patients was 5.53 (SD= 2.66) years. Patients treated with KOH solution had a significant decrease in skin lesions (RR 2.93; 95% CI 1.67-5.15; p=0.0002) (Figure 1), with no significant heterogeneity noted in forest plot analysis. Additionally, there was no significant risk of relevant adverse effects recurrence between the KOH and placebo groups (RR 1.73; 95% CI 0.67-4.47; p= 0.26) (Figure 2).

Conclusion(s): The findings indicate that treatment with 10% potassium hydroxide solution significantly improves lesion clearance in pediatric patients with molluscum contagiosum compared to placebo. This suggests that KOH is an effective and viable therapeutic option for managing this infection.

Figure 1 - Complete clearence


Figure 2 - relevant adverse effects