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Efficacy and Safety of Topical Cantharidin Treatment for Molluscum Contagiosum and Warts: A Systematic Review

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Abstract

Background and Objective

Topical cantharidin is routinely used for the treatment of molluscum contagiosum and warts. The objective of this systematic review is to assess the efficacy and safety of topical cantharidin treatment for molluscum contagiosum and warts.

Methods

We performed a systematic review of studies assessing topical cantharidin treatment of molluscum contagiosum or warts. We searched the databases of Cochrane, EMBASE, GREAT, LILACS, MEDLINE, and Scopus. Two authors performed the study selection and data extraction.

Results

Twenty studies (1958–2018) met inclusion/exclusion criteria. Twelve studies assessed warts, and eight studies assessed molluscum contagiosum. Overall, 1752 patients were included (range 0.3–62 years; specified in 15 studies). Clearance rates with topical cantharidin for molluscum contagiosum were variable (range 15.4–100%). Significant clearance of warts with maintenance of clearance was demonstrated with topical cantharidin alone. Topical cantharidin in combination with podophyllotoxin and salicylic acid demonstrated efficacy for plantar warts (pediatric and adult; clearance rate range 81–100%; four studies had 100% clearance), with the majority clearing after a single treatment. Satisfaction with cantharidin therapy was high, especially in molluscum contagiosum. Pain (7–85.7%), blistering (10–100%), and hyper-/hypopigmentation (1.8–53.3%) were the most commonly occurring adverse effects with cantharidin treatment.

Conclusion

Topical cantharidin demonstrated clearance of warts, particularly in combination with podophyllotixin and salicylic acid, and modest benefit for pediatric molluscum contagiosum with good tolerability and safety.

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Author information

Authors and Affiliations

  1. Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Paras P. Vakharia & Rishi Chopra

  2. Department of Dermatology, Mount Sinai West of the Icahn School of Medicine, New York, NY, USA

    Nanette B. Silverberg

  3. Department of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, 676N. Saint Clair St, Suite 1600, Chicago, IL, 60611, USA

    Jonathan I. Silverberg

  4. Northwestern Medicine Multidisciplinary Eczema Center, Chicago, IL, USA

    Jonathan I. Silverberg

Authors
  1. Paras P. Vakharia
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  2. Rishi Chopra
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  3. Nanette B. Silverberg
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  4. Jonathan I. Silverberg
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Contributions

JIS had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. JIS and NBS provided the study concept and design. PV and RC obtained the data. All authors analyzed and interpreted the data, drafted the manuscript, and critically revised the manuscript for important intellectual content. PV and JIS conducted the statistical analysis. JIS obtained the funding.

Corresponding author

Correspondence to Jonathan I. Silverberg.

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Funding

This publication was made possible with support from the Agency for Healthcare Research and Quality (Grant no. K12 HS023011) and the Dermatology Foundation.

Conflict of interest

Jonathan I. Silverberg, Nanette B. Silverberg, Paras P. Vakharia, and Rishi Chopra have no conflicts of interest directly relevant to the content of this article.

Ethics Approval

This study was exempt from institutional review board approval.

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Vakharia, P.P., Chopra, R., Silverberg, N.B. et al. Efficacy and Safety of Topical Cantharidin Treatment for Molluscum Contagiosum and Warts: A Systematic Review. Am J Clin Dermatol 19, 791–803 (2018). https://doi.org/10.1007/s40257-018-0375-4

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  • DOI: https://doi.org/10.1007/s40257-018-0375-4

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