Embase, PubMed, and the Cochrane Library were searched for articles published between January 1, 1990, and November 31, 2020. Eligible studies were randomized clinical trials (RCTs) of interventions in immunocompetent children and adults with genital/non-genital molluscum contagiosum lesions.
Twelve interventions from 25 RCTs including 2,123 participants were assessed. Compared with the placebo, ingenol mebutate had the most significant effect on complete clearance (odds ratio [OR] 117.42, 95% confidence interval [CI] 6.37-2164.88), followed by cryotherapy (OR 16.81, 95% CI 4.13-68.54), podophyllotoxin (OR 10.24, 95% CI 3.36-31.21), and potassium hydroxide (KOH) (OR 10.02, 95% CI 4.64-21.64). Data on adverse effects were too scarce for quantitative synthesis.
Ingenol mebutate, cryotherapy, podophyllotoxin, and KOH were more effective than the other interventions in achieving complete clearance, but safety concerns regarding ingenol mebutate have recently been reported. Due to the possibility of spontaneous resolution, observation is also justified for asymptomatic infection. Factors including adverse effects, cost, patient preference, and medical accessibility should be considered.
方法:Embase,PubMed,搜索了Cochrane图书馆在1990年1月1日至2020年11月31日之间发表的文章。符合条件的研究是对免疫功能正常的儿童和患有生殖器/非生殖器传染性软体动物病变的成人进行干预的随机临床试验(RCT)。
结果:评估了来自25个随机对照试验的12项干预措施,包括2,123名参与者。与安慰剂相比,麦桂醇对完全清除的影响最显著(比值比[OR]117.42,95%置信区间[CI]6.37-2164.88),其次是冷冻疗法(OR16.81,95%CI4.13-68.54),鬼臼毒素(OR10.24,95%CI3.36-31.21),和氢氧化钾(KOH)(OR10.02,95%CI4.64-21.64)。关于不利影响的数据太缺乏,无法进行定量综合。
结论:丁香酚,冷冻疗法,鬼臼毒素,和KOH在实现完全清除方面比其他干预措施更有效,但最近有报道称,有关美因特林的安全性问题。由于自发解决的可能性,观察无症状感染也是合理的。因素包括不利影响,成本,患者偏好,应该考虑医疗可及性。